Mrkt Revenue Integrity Analyst

Meadowview Regional Medical Center

This job is responsible for ensuring that all appropriate billing charges are being captured, documented, charged, and reimbursed for the assigned departments and facilities in accordance with policies and procedures, and applicable regulatory standards and requirements. Receives and processes Charge Description Master (CDM) requests that are submitted by the facilities, validates and loads all decisional mass rate increases, and maintains the standard CDM for assigned departments and answering questions related to billing for those departments.

ESSENTIAL FUNCTIONS

Responsible for reviewing and maintaining charge description master (CDM), and/or other pertinent regulations and policies, ensuring all data elements are accurate and comply with all payor requirements.Resolves issues that arise from information submitted and revenue cycle issues.Provides validation reviews, audits, documentation and training for the area of knowledge, sharing information with Finance, Medical Records and other revenue producing areas or departments.May conduct daily charge capture audit and education in high performing areas (i.e., Pharmacy, Observation, Surgery, Emergency Department, Injection and Infusions, etc.).May develop and deliver charge capture education to hospital staff.Serve as an active participant in the development and implementation of performance improvement program for charge capture.Maintain responsibility for ensuring integrity of the documents that support patient billing.May review claim denials and rejections pertaining to billing, authorization, coding and documentation requirements.Provide periodic updates to the Chief Financial Officer, Chief Nursing Officer, or Department Directors for appropriate action based on areas of highest risk associated with missing or inappropriate charge capture.Provide detailed information from charge capture reviews when specific departments or areas are identified with under/over-charging issues.Serve as Revenue Integrity subject matter expert (SME) for charging and documentation.Keep abreast of Ambulatory Payment Classification (APC) and Current Procedural Terminology (CPT) code changes to ensure preparation for outpatient prospective reimbursement, identify areas affected and work to ensure compliance.Responsible for processing changes and maintaining compliance and revenue integrity; assist with oversight of Charge Master.Maintain current knowledge of insurance plans and government programs to ensure compliance with current hospital policies and procedures; determine how proposed changes in regulations will impact the institution and disseminate the information to hospital staff.Maintain working knowledge of the flow of information for the billing process and the clinical documentation that provides support for the billing process.Process CDM requests and maintain current knowledge of relevant regulations and billing guidelines.



Job Requirements:
Minimum EducationAssociate's Degree RequiredMinimum Work ExperienceMinimum of 5 years’ experience in Health Information Technology or Revenue Integrity/Charge Capture.Required SkillsBusiness Mathematical Skills -- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages and to draw and in-terpret graphs.Moderate Computer Skills – Frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc. Ability to create, maintain and incorporate simple functions into documents, spreadsheets, databases, and presentations to support business objectives.Moderate Communication – Regularly uses moderately complex oral and written skills. May train others in functional areas, interact with others and make presentations to department or middle management.Routine Business Problems – Problems encountered are routine, somewhat repetitive and generally solved by following clear directions and procedures.Job Specific Impact -- Decisions generally affect own job or assigned functional area.Moderate Independent Judgement -- Results are defined; sets personal goals and determines how to achieve results with few or no guidelines to follow; supervisor/manager provides broad guidance and overall direction.Moderate Planning/Organization -- Handle multiple tasks simultaneously with moderate complexity.Required LicensesCoder, Health Information
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.
Posted
10/06/2021
Type
Full time
Salary Range
$58,000.00 - 90,000.00
per Year
Salary range estimated by
Location
Maysville, KY 41056, US
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