At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

Job Summary:

Under the direction of the Director of Revenue Cycle, the Revenue Integrity Analyst plays a leadership role and is tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, superb analytic and organizational skills, and the ability to influence but not directly manage the work of others.

Essential Job Functions and Responsibilities:

• Evaluates current charging and coding structures and processes in revenue generating departments to ensure appropriate capture and reporting of revenue and compliance with government and third party payer requirements.
• Maintain and update Monthly KPI Dashboard, relay budget discrepancies to leadership.
• Assesses the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents used to capture revenue.
• Identify underpayment trends by payer.
• Update Master Fee schedule yearly.
• Performs month end process.
• Run various month end reports for Revenue Cycle Manager to include charge, diagnosis, encounter and payment files to STRATA database.
• Validation of patient balances transferred to Collection agency. Reconciliation of reporting and adjustment of balances in EHR system.
• Leads and participates in projects related to revenue cycle initiatives.
• Analyzes billing error and denial data to identify root causes. Identify trends by payer, denial code, CPT code, physician and specialty.
• Run weekly unlocked encounters report.
• Executes on work plans to correct identified deficiencies.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications.
• Review payer bulletins and highlight key areas of any CPT code changes and authorization requirements. Communicate to the Revenue Cycle team and the Ambulatory Administrative team.
• Executes on work plans to adapt systems and processes to accommodate changes.
• Assisting in the design and implementation of charge capture/billing workflow improvements.
• Participates in chargemaster (CDM) maintenance efforts by reviewing whether charges accurately reflect provided services/supplies and are consistent with industry best practices. Collaborating with the Sr. Revenue Analyst to update the CDM as needed.
• Work in conjunction with the Hospital Analyst.
• Ad Hoc reporting

Educational / Minimum Requirements:

Bachelors Degree in appropriate discipline (Business Administration, Accounting, and Finance) or equivalent experience.

Three to five years of hospital billing experience preferred.

Experience using Meditech Patient Accounting.

Knowledge of CPT-HCPCS, third party reimbursement methodologies, and revenue cycle process.

Expert knowledge of inpatient and outpatient billing requirements, coding guidelines and CMS Medicare reimbursement methodology.

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. Proficient in using Microsoft Excel, PowerPoint and Word.

Bristol Hospital Mandated Educational Requirements:

General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

Intermediate knowledge of Excel and Word is required. MediTech or other hospital billing systems is beneficial.

Physical Requirements:

Extending sitting at desk and/or computer terminal. Extensive eye usage.

Work Environment:

Normal office conditions.

Cognitive Requirements:

Must be able to think independently, analyze information, execute written and oral instructions, follow directions, and have good mathematical aptitude.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

Bristol Health is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions at Bristol Health are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other non-merit factor. Bristol Health will not tolerate discrimination or harassment based on any of these characteristics.

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Bristol, CT 06010: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Required)

Experience:

• Hospital Billing: 3 years (Required)

Work Location: One location