R1 RCM

Technology-driven revenue cycle management services for healthcare providers.

Revenue Integrity Analyst II

AnalystAnalystFull TimeRemoteTeam 10,001+Since 2017H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

37 days ago

Salary

$46.6K - $66.1K / year

Bachelor DegreeEnglish

Job Description

• Prepares Excel analysis, including V-Lookups and pivot tables. • Gathers and compiles data in a systematic fashion, clearly documenting assumptions, and validating accuracy of information to resolve inconsistencies. • Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines. • Conducts Charge Capture Audits: Review and analyze patient records, billing data, and financial statements to ensure charge and coding compliance. • Identify discrepancies or errors and develop action plan for future state resolution. • Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams. • Monitor regulatory changes and payer updates that may impact charge master and revenue integrity. • Collaborates with various departments to resolve CDM or RI discrepancies (Utilization Management (UM), Clinical Documentation Integrity (CDI), RCM, Coding Services, Clinical Departments, and Health Information Management (HIM)). • Serve as a liaison during system upgrades, new service implementation, and pricing reviews.

Job Requirements

  • Expertise in charge description master, CPT/HCPCS, NCCI, MUE, pricing, and payer contracts.
  • Strong skills in V-Lookups and pivot tables.
  • Systematic data gathering, compilation, and validation.
  • Accurate documentation and data accuracy.
  • Understanding of billing and revenue recognition.
  • Conducting charge capture audits and identifying discrepancies.
  • Analyzing data and summarizing findings.
  • Running and extracting accurate reports.
  • Working with various departments (UM, CDI, RCM, etc.).
  • Strong verbal and written skills.
  • Problem-Solving: Developing action plans for discrepancies.
  • Stakeholder Management: Interacting with executive stakeholders (CFO, CCO, CMO).
  • Certification: CPC or COC + ROCC or at least experience in RAD ONC

Benefits

  • Competitive benefits package
  • Annual bonus plan at a target of 5.00%

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