Revenue Integrity Analyst

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

• Sentara Healthcare is currently seeking an experienced professional to join our team as a Revenue Integrity Analyst---Remote

•   * This is a 100% Remote position for residents of the following approved states:

  • Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine Maryland, Minnesota, Nebraska, Nevada, North Carolina, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming 

  Minimum Requirements:

  • Bachelor Level Degree or previous related experience in lieu of Degree
  • 2-3 years of healthcare experience with Degree
  • Experience with Revenue Cycle.

  Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation.  Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.

  Job Responsibilities:

  • With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
  • Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
  • Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications. 
  • Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
  • Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
  • Participates in complex projects related to revenue cycle initiatives. 
  • Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
  • Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials. 
  • Work and analyze billing error and denial data to identify root causes. Executes work plans to correct identified deficiencies.
  • Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.  
  • Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting. 
  • Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned. 

  Job Requirements:

  • Bachelor’s degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
  • Three years of healthcare-related experience
  • Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel. Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
  • Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers
  • Knowledge of CPT/ HCPCS codes and Revenue Codes. Understanding of revenue integrity processes and their impact throughout the revenue cycle. Must demonstrate excellent communication skills including oral and written comprehension and expression.

  As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers.  We offer a variety of amenities to our employees, including, but not limited to: 

  • Medical, Dental, and Vision Insurance
  • Paid Annual Leave, Sick Leave
  • Flexible Spending Accounts
  • Retirement funds with matching contribution
  • Supplemental insurance policies, including legal, Life Insurance and AD&D among others
  • Work Perks program including discounted movie and theme park tickets among other great deals
  • Opportunities for further advancement within our organization

   

  Sentara employees strive to make our communities healthier places to live.  We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.  For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)

   

  For Washington State Residents: $66,175.20 - $91,313.04

  A remote candidate must be a resident of one of the following approved states:

  • Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming 

Job Summary

Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.

Principal Duties and Responsibilities:
*Support the following service areas/departments: Operating Room, Labor & Delivery, Treatment Room, Emergency Department, and Supplies.
*With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
*Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
*Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
*Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
*Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
*Participates in complex projects related to revenue cycle initiatives.
*Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
*Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
*Work and analyze billing error and denial data to identify root causes. Executes work plans to correct identified deficiencies.
*Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
*Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
*Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.

Bachelor’s degree required preferably in Healthcare Administration, Accounting, Finance, or a related field. Three years of healthcare-related experience. Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel. Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus. Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers. Knowledge of CPT/ HCPCS codes and Revenue Codes. Understanding of revenue integrity processes and their impact throughout the revenue cycle. Must demonstrate excellent communication skills including oral and written comprehension and expression.

Qualifications:

BLD - Bachelor's Level Degree: Accounting, BLD - Bachelor's Level Degree: Finance, BLD - Bachelor's Level Degree: Health Administration

Certified Outpatient Coder (COC) - Certification - Other/National, Certified Professional Coder (CPC) - Certification - American Academy of Professional Coders (AAPC)

Healthcare

Skills

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

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