Note: The job is a remote job and is open to candidates in USA. Medasource is seeking a Revenue Integrity Analyst II-III to support healthcare revenue integrity operations and Epic go-live initiatives. The role focuses on charge capture, billing and denial analysis, pricing reviews, reconciliation audits, compliance, reporting, and operational improvement across clinical, financial, and administrative teams.
Responsibilities
- Assists Market Director in supporting facilitates annual CDM pricing review in alignment with Finance and Reimbursement policies and guidelines and serves as a point of contact for strategic pricing vendors
- Performs department charge process and charge reconciliation audits to ensure compliance with hospital and department policy and procedures. Creates and modifies policies and procedures relating to gross revenue and reconciliation processes. Educates applicable hospital staff on the policies and procedures
- Identifies trends in charging issues and communicates to the Manager of Revenue Integrity and the charging department
- Works with various departments to obtain the necessary information to perform charge analysis and/or reconciliation. This includes but is not limited to, Health Information Management Department, clinical areas, Case Managers and Physicians
- Lead complex revenue integrity, charge capture, and operational improvement initiatives, including support for new service lines, complex procedures, and workflow optimization efforts
- Analyze and communicate the financial, operational, and compliance impact of revenue cycle issues to stakeholders at all levels, including Nursing leadership, Directors, Sr. Directors, CFOs, and CNOs, to drive informed decision-making and alignment
- Partner with clinical, operational, and financial teams to identify revenue integrity opportunities, implement process improvements, and ensure sustainable outcomes across the organization
- Analyzes billing edit and denial data for root cause and trends to be communicated back to department directors/managers
- Develops educational tools to help departments avoid billing edits/ denials in the future
- Develop/provide reports for managers regarding billing edit and denial tracking reports
- Documents all findings in the Financial System
- Tracks and trends gross revenue
- Provides assistance with charge capture and/or coding issues within departments
- Assists with yearly CDM price increase and pricing of new procedures
- Processes billing invoices for agency/client billing
- Regularly attends Corporate HIM Coding and Revenue Integrity updates and seminars
- Assists with additional Finance department functions as needed
Skills
- • Epic Experience
- • 3-5 Years Revenue Integrity Experience
- • Knowledge of revenue cycle processes including charge capture and coding, and strong understanding of reimbursement methodologies
- • Ability to work independently, set priorities, and manage work accurately and timely
- • Willingness to travel to other work settings is essential
- • Able to handle confidential information
- • Must have the ability to read and analyze data for specific audience: Excel, SMS, word processing, electronic charts
- • The ability to extract data from computer programs is essential
- • Must display sound judgment, tact, discretion, and ability to develop and sustain a cooperative working relationship with all levels of associates and customers
- • Strong Excel skills and Access Database skills
- • Knowledge of payer guidelines
- • Certified Coding Specialist (CCS)
- • Certified Professional Coder (CPC)
- • Certified Coding Associate (ACA)
Benefits
- Fully remote
- Contract-to-hire arrangement for 6-12 months
Company Overview