Revenue Integrity Analyst II Remote

Position #: 250005Q5
Position: Revenue Integrity Analyst II Remote
UH Facility: University Hospitals
Shift: Days
Status: Full-time
Work Days of Week: M-F

City: Shaker Heights

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From entry to executive level, every position and every professional at University Hospitals has a direct impact on our ability to offer excellent care to our patients, their families and our community.

Join Us and Be the difference in Advancing the Science of Health and the Art of Compassion.

Equal Opportunity Employer – veterans and individuals with disabilities

JOB DESCRIPTION & QUALIFICATIONS

Description

A Brief Overview

This position is responsible for daily Charge Description Management (CDM), and monitoring, analyzing and ensuring compliance with payer operations.

What You Will Do

Supports UHHS clinical areas, new/existing service lines and departments (this includes Revenue Cycle Management) as follows:
• Continually reviews and proactively communicates governmental policy, payer/vendor updates, newsletters and internal Management initiatives to ensure that UHHS services provided to patients are captured and billed in compliance with government regulation, contractual obligation, internal policy/standards or business objectives.
• Expected to identify, report, and participate in the resolution of any potential or actual revenue/charge related issues.
• Monitors, and provides additions and updates to the CDM for entry into system master files/tables.
• Provides additions and updates for system charge routing, edits, and/or errors.
• Works in conjunction with Sr. Revenue Integrity Analysts, Managed Care/Contracting, and Finance for end of year updates including pricing changes.
• Works in conjunction Sr. Revenue Integrity Analysts to support annual maintenance and routine analysis of the CDM.
• Reviews patient records and can assist with account fixes, charge reconciliation for other departments based on clinical documentation.
• Responds to departmental charging inquiries timely and seeks guidance when appropriate.
• Works with Coding and other clinical departments to identify/fix errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.
• Contributes in the support of quarterly improvement initiatives as directed by department director or manager.
• Train and assist in daily resolution of billing edits/errors that are holding revenue, by reviewing the medical records and other applicable documentation.
• Monitors applicable Revenue Integrity KPIs.
• Assist Revenue Cycle departments with special procedures and various duties as assigned.
• Success completion of proficiency required to gain access to applicable systems.
This role requires professional certification maintenance in good standing.

Additional Responsibilities

Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Qualifications

Education

Technical school (Required) or
Associate’s Degree in finance or science (Required) or
equivalent combination of education and experience. (Required)

Work Experience

3+ years experience in revenue cycle processes and hospital/medical billing to include CDM, UB, and 1500. (Required)

Knowledge, Skills, & Abilities

Advanced knowledge of code data sets to include CPT, HCPCS, and ICD 10. Advanced knowledge of NCCI edits, and Medicare LCD/NCDs. (Required proficiency)
Understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations. (Required proficiency)
Detail-oriented and organized, with good analytical and problem-solving ability. (Required proficiency)
Notable client service, communication, presentation, and relationship building skills. (Required proficiency)
Ability to function independently and as a team player in a fast-paced environment. (Required proficiency)
Must have strong written and verbal communication skills. (Required proficiency)
PC proficiency in MS Office. (Required proficiency)
Proficiency with VitalWare, Soarian, or Epic is a plus. (Preferred proficiency)

Licenses and Certifications

Certified Coding Specialist (CCS) Applicable professional certification through AHIMA (Required) and
Registered Health Information Technologist (RHIT) Applicable professional certification through AHIMA (Required) and
Registered Health Information Administration (RHIA) Applicable professional certification through AHIMA (Required) or
Certified Professional Coder (CPC) Applicable professional certification through AAPC (Required) and
Certified in Infection Control (CIC) Applicable professional certification through AAPC (Required) and
Certified Outpatient Coder (COC) Applicable professional certification through AAPC (Required)

Physical Demands

Standing Occasionally
Walking Occasionally
Sitting Constantly
Lifting Rarely 20 lbs
Carrying Rarely 20 lbs
Pushing Rarely 20 lbs
Pulling Rarely 20 lbs
Climbing Rarely 20 lbs
Balancing Rarely
Stooping Rarely
Kneeling Rarely
Crouching Rarely
Crawling Rarely
Reaching Rarely
Handling Occasionally
Grasping Occasionally
Feeling Rarely
Talking Constantly
Hearing Constantly
Repetitive Motions Frequently
Eye/Hand/Foot Coordination Frequently

Travel Requirements

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LOCATION

Working at University Hospitals

Careers at University Hospitals offers opportunities to provide care locally in the Cleveland area with the power to impact healthcare nationwide. As a leader in our industry, our staff share a commitment to Be the Difference in the lives of our patients and our communities, from Northeast Ohio and beyond. Take a look at this video to discover how we’re building an organization for the future, today. Note: video content was obtained prior to the COVID-19 pandemic.

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Contact Us

To contact University Hospitals Human Resources department, or to request a reasonable accommodation, please call 216-767-8900 or send us an email at employment@uhhospitals.org

Equal Employment Opportunity Statement

It is the policy of University Hospitals to provide equal opportunity to all of our employees and applicants for employment. Decisions concerning employment, transfers and promotions or other conditions of employment are all made upon the basis of the best qualified candidate without regard to race, color, national origin, age, religion, veteran status, disability, gender, sexual orientation, gender identity, or marital status in accordance with Federal and Ohio law. A qualified individual with a disability will be considered for employment on the same basis as non- disabled applicants if he/she can perform the essential functions of the job sought, with or without a reasonable accommodation, and without imposing a direct threat to the health or safety of others or him/herself. EEO is the Law

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