Erlanger
Revenue Integrity Analyst, Physician Billing - Remote
Erlanger, Chattanooga, Tennessee, United States, 37450
Revenue Integriy Analyst, Physician Billing
Location:
Erlanger Baroness Hospital, Chattanooga, TN
Job Summary The Revenue Integriy Analyst plays a pivotal role in ensuring financial health for the professional services team by meticulously managing the charge master, regulation code changes, work queues, charge capture, charge reconciliation, reporting, and analytical trending. The position identifies root causes, maintains processes to ensure charge capture, and provides analytical insight regarding charges that are not captured accurately or consistently. It recommends modifications to established practices and procedures or system functionality and manages implementation of those changes.
Responsibilities
Charge Master
Evaluates current charging processes to diagnose the root cause of any charge inefficiencies and ensures standard charge practices are implemented.
Analyzes changes to coding and billing rules and regulations and uses independent decision‑making to ensure appropriate updates to CDM and charge processes are implemented.
Prepares and presents quarterly and annual CPT/HCPCS changes, annual pricing updates and provides education material and presentation.
Conducts thorough research to ensure the Charge Description Master (CDM) is maintained regularly.
Leads efforts of collaboration with multi‑disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of the charge master.
Operational Improvement
Collaborates with stakeholders on revenue enhancement projects as needed.
Provides leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives.
Conducts thorough analysis of billing errors and denial data to diagnose root causes, utilizing independent decision‑making to execute work plans to correct identified deficiencies.
Stays up to date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively shares knowledge with the team.
Performs quality assurance on team members as needed.
Trends and analyzes key data to identify areas for additional education.
Charge Capture
Serves as subject‑matter expert of charge capture methodologies and helps investigate and solve charging issues, providing recommendations to clinical departments and hospital staff.
Diagnoses root‑cause issues of charge problems and provides education for best‑practice recommendations for improvement.
Conducts root‑cause analysis on late charge reporting and provides education for timely charge capture.
Ensures effective monitoring and internal control processes are in place to improve revenue capture.
Identifies operational performance and revenue opportunities through detailed data review.
Coordinates operational objectives by contributing information and recommendations to strategic plans and reviews and by preparing and completing action plans.
Knowledge, Skills & Abilities
Collaboration – Works cooperatively with teams and partners internally and externally as needed.
Accountability – Accepts personal responsibility for outcomes and meets commitments.
Time Management – Manages personal time and resources efficiently.
Takes Initiative – Proactively pursues goals and outcomes beyond requirements.
Mission‑Alignment – Adopts a philosophy consistent with Erlanger Health’s mission, vision, and values.
Interpersonal – Facilitates seamless communication with clinical staff.
Coding Conventions – Solid understanding of coding conventions and current third‑party payer rules.
Third‑Party Knowledge – Current knowledge of third‑party payer rules and regulations.
Management – Knowledge of management/supervision and ability to organize staff work.
Computer Literacy – Confidently monitors and obtains information from electronic medical records and database systems.
Independence – Works independently and demonstrates problem‑solving skills.
Critical Thinking – Applies critical thinking to complex issues.
Medical Records – Knowledge of requirements for complete medical records per Erlanger Health bylaws and regulatory bodies.
Communication – Demonstrates command of written and telephone communication skills.
Confidentiality – Maintains confidentiality and adheres to federal, state, HIPAA, and hospital policy regarding patient health information privacy.
Organization – Demonstrates ability to prioritize during job performance.
Technical – Knowledge of Windows OS, Microsoft Office products, Electronic Health Record System, Document Imaging System, and office equipment.
Education
Required: High school graduate or equivalent; CPI Annual/Biannual training if applicable; must have working‑level knowledge of the English language.
Preferred: Associate’s or Bachelor’s degree in Business Administration, Finance, or related field.
Experience
Required: 3–5 years of related experience with extensive knowledge of ICD‑10‑CM and CPT coding principles; strong organizational, written, and verbal communication skills.
Preferred: N/A
License/Certification/Registration
Required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).
Preferred: Certified Revenue Cycle Specialist (RCMS), Certified Health Information Administrator (CHRI), or Certified Revenue Cycle Specialist (CRCS).
Other Details Standard Hours: Regular
Seniority Level: Mid‑Senior level
Employment Type: Full‑time
Job Function: Finance and Sales
Industries: Hospitals and Health Care
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Erlanger Baroness Hospital, Chattanooga, TN
Job Summary The Revenue Integriy Analyst plays a pivotal role in ensuring financial health for the professional services team by meticulously managing the charge master, regulation code changes, work queues, charge capture, charge reconciliation, reporting, and analytical trending. The position identifies root causes, maintains processes to ensure charge capture, and provides analytical insight regarding charges that are not captured accurately or consistently. It recommends modifications to established practices and procedures or system functionality and manages implementation of those changes.
Responsibilities
Charge Master
Evaluates current charging processes to diagnose the root cause of any charge inefficiencies and ensures standard charge practices are implemented.
Analyzes changes to coding and billing rules and regulations and uses independent decision‑making to ensure appropriate updates to CDM and charge processes are implemented.
Prepares and presents quarterly and annual CPT/HCPCS changes, annual pricing updates and provides education material and presentation.
Conducts thorough research to ensure the Charge Description Master (CDM) is maintained regularly.
Leads efforts of collaboration with multi‑disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of the charge master.
Operational Improvement
Collaborates with stakeholders on revenue enhancement projects as needed.
Provides leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives.
Conducts thorough analysis of billing errors and denial data to diagnose root causes, utilizing independent decision‑making to execute work plans to correct identified deficiencies.
Stays up to date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively shares knowledge with the team.
Performs quality assurance on team members as needed.
Trends and analyzes key data to identify areas for additional education.
Charge Capture
Serves as subject‑matter expert of charge capture methodologies and helps investigate and solve charging issues, providing recommendations to clinical departments and hospital staff.
Diagnoses root‑cause issues of charge problems and provides education for best‑practice recommendations for improvement.
Conducts root‑cause analysis on late charge reporting and provides education for timely charge capture.
Ensures effective monitoring and internal control processes are in place to improve revenue capture.
Identifies operational performance and revenue opportunities through detailed data review.
Coordinates operational objectives by contributing information and recommendations to strategic plans and reviews and by preparing and completing action plans.
Knowledge, Skills & Abilities
Collaboration – Works cooperatively with teams and partners internally and externally as needed.
Accountability – Accepts personal responsibility for outcomes and meets commitments.
Time Management – Manages personal time and resources efficiently.
Takes Initiative – Proactively pursues goals and outcomes beyond requirements.
Mission‑Alignment – Adopts a philosophy consistent with Erlanger Health’s mission, vision, and values.
Interpersonal – Facilitates seamless communication with clinical staff.
Coding Conventions – Solid understanding of coding conventions and current third‑party payer rules.
Third‑Party Knowledge – Current knowledge of third‑party payer rules and regulations.
Management – Knowledge of management/supervision and ability to organize staff work.
Computer Literacy – Confidently monitors and obtains information from electronic medical records and database systems.
Independence – Works independently and demonstrates problem‑solving skills.
Critical Thinking – Applies critical thinking to complex issues.
Medical Records – Knowledge of requirements for complete medical records per Erlanger Health bylaws and regulatory bodies.
Communication – Demonstrates command of written and telephone communication skills.
Confidentiality – Maintains confidentiality and adheres to federal, state, HIPAA, and hospital policy regarding patient health information privacy.
Organization – Demonstrates ability to prioritize during job performance.
Technical – Knowledge of Windows OS, Microsoft Office products, Electronic Health Record System, Document Imaging System, and office equipment.
Education
Required: High school graduate or equivalent; CPI Annual/Biannual training if applicable; must have working‑level knowledge of the English language.
Preferred: Associate’s or Bachelor’s degree in Business Administration, Finance, or related field.
Experience
Required: 3–5 years of related experience with extensive knowledge of ICD‑10‑CM and CPT coding principles; strong organizational, written, and verbal communication skills.
Preferred: N/A
License/Certification/Registration
Required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).
Preferred: Certified Revenue Cycle Specialist (RCMS), Certified Health Information Administrator (CHRI), or Certified Revenue Cycle Specialist (CRCS).
Other Details Standard Hours: Regular
Seniority Level: Mid‑Senior level
Employment Type: Full‑time
Job Function: Finance and Sales
Industries: Hospitals and Health Care
#J-18808-Ljbffr