Monroe Regional Hospital
The Revenue Integrity Analyst will utilize Charge Description Master (CDM) management software to maintain a complete, accurate and standardized CDM, with uniform data elements and consistency with clinical practice.
They will provide support, education and guidance to Clinical and Administrative Departments in order to maximize appropriate revenue for the system.
The Revenue Integrity Analyst will be responsible for reviewing, analyzing, and trending information being reported in order to identify the root-cause of issues and facilitate operational changes to improve net revenue and reductions in denials.
- Process CDM additions, deletions and change requests while maintaining compliance with local, state and federal regulatory agencies.
- Monitor government and commercial payers for updates and changes to billing requirements. Communicate and educate clinical and administrative staff on any actions required to comply with new regulations.
- Identify when re-billing is needed and coordinated the re-billing process Billing team.
- Be responsible for the training of hospital departments regarding compliant charge practice; the CDM maintenance process; annual CPT/HCPC code updates; and charge capture improvement.
- Collaborate with the clinical departments and enterprise Information System team to ensure that the appropriate ancillary/clinical modules are updated appropriately.
- Serve as subject matter expert related to charging and billing issues and assist in developing and maintaining CDM related policies and procedures.
- Audit charges being captured by clinical departments for accuracy and completeness. Ensure that charges are crossing to the bill intended.
- Bachelor’s degree in Nursing, Accounting, Finance, Healthcare Administration or Business Administration or 3 years of direct Chargemaster experience.
- Minimum of 5 years of health care experience with at least 3 years of Chargemaster or billing or coding with some experience/exposure with Chargemaster.
- Proficient in Microsoft Excel, PowerPoint and Word.
- Experience with Chargemaster maintenance or proficient knowledge of Chargemaster components (CPT, HCPCs, Revenue Codes).
- Experience using Chargemaster Software.
- Knowledge of CPT-HCPCs, third party reimbursement methodologies, and revenue cycle process.
- Thorough understanding of the CDM relationship to general ledger, cost accounting, cost reporting, budget, coding, billing, and compliance in a hospital setting.
- Expert knowledge of inpatient and outpatient billing requirements, coding guidelines, and CMS Medicare reimbursement methodology.
- Must be flexible and able to succeed in a changing environment, including traveling to each facility.
- Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others.
- Strong quantitative, analytical and organizational skills.
- Ability to respond to complex inquiries in a professional and efficient manner.
- Revenue Cycle: 3 years
- Inpatient and outpatient billing : 2 years
- Third party reimbursement methodologies: 3 years
- Coding certification
- Bachelor’s (preferred)
- AHIMA or AAPC credential (preferred)
- Short and long term disability
- Life insurance
- Medical, dental and vision
Instructions for Resume Submission:
Email resume to firstname.lastname@example.org