Revenue Integrity Charge Description Master Analyst

Job Overview: 

Fairview is looking for a Revenue Integrity Charge Description Master Analyst to join our team. The Revenue Integrity Charge Description Master Analyst serves as a liaison between organizational leadership, end-users, project team members, Revenue Cycle, and other internal or external resources with the objective to achieve operational efficiency, compliance, and legitimate reimbursement. Analysts are responsible for analysis and maintenance of the charge description master (CDM) file in the Epic EHR system to ensure compliance with CPT/HCPC coding, National Uniform Billing Committee (NUBC), revenue code, billing, payor, and regulatory requirements. This role makes recommendations on structural requirements, charge mechanisms and reimbursement implications for billing within the Epic EHR system. The Analyst also evaluates users interacting with the EHR system and associated softwares to identify education or system enhancement opportunities that support operational excellence and efficiency. This role performs application analysis concepts, including evaluation of current state against desired future state with consideration to policy, compliance, evidence, quality, operational standardization, and workflow implications to monitor for, identify, and prevent revenue leakage.

Position Details: 

• 1.0 FTE (80 hours per pay period)
• day shift
• no weekends
• fully remote, salaried position

Responsibilities

• Performs in-depth analysis of charging workflows and other technical issues associated with Epic charging systems and applicable software.
• Defines and co-develops business requirements that allow for optimization of the system to enhance operational workflows.
• Understands and contributes to the process or enablement of collecting expected payment by ensuring accurate and compliant charge capture, coding and documentation outcomes.
• Supports the creation of educational materials for staff and process improvement needs.
• Researches and interprets CPT/HCPC coding and billing regulatory requirements to recommend and develop compliant solutions for CDM set up.
• Completes timely and accurate updates to the CDM that contribute to generating clean claims, enabling the collection of expected payments.
• Participates in ongoing coordination with revenue producing departments to ensure the accuracy of all CDM data elements and assists with resolution of CDM related revenue issues
• Conducts service line quality reviews leveraging reporting tools by evaluating process, functional and/or revenue gaps to determine resolution.
• Investigates, compiles, analyzes, accurately interprets, and validates data.
• Summarizes findings and opportunities identified in the data to support leadership decision making and executes corrective projects as needed.
• Develops, manages, trains, monitors and supports reconciliation processes.
• Provides continuous quality control and process improvement through work queue monitoring, variance checks, analysis, troubleshooting and detailed research.
• Develops, designs, and maintains visuals and/or reports.
• Acts as a point of contact/subject matter expert for charge application process and maintains a strong understanding of system functionality, software applications, and business workflow and objectives to appropriately interpret data and support leadership decision making.
• Maintains extensive knowledge of ICD-10-CM, CPT/HCPCs procedure coding and supports regular updates of CPT/HCPCS and regulatory changes, including the identification of codes that have been deleted, added, or replaced. Ensures that the appropriate system changes, supporting education, and proper communication is completed.
• Tests, identifies new conditions to test, and analyzes results of testing of new workflows and system functionalities to safeguard charging and revenue integrity.
• Outlines requirements for new analytic tools including necessary fields, appropriate calculations, data definitions, and integration points.
• Researches, documents, and facilitates resolution to charging issues reported by end-users.
• Develops and maintains relationships with key partners to explore and develop potential solutions to systematic issues, ensuring revenue integrity.
• Applies critical thinking knowledge to core functions to take action and ensure escalation of system problems and operational needs.
• Upholds timely and accurate work.
• Understands and adheres to Revenue Cycle’s Escalation Policy.
• Initiates judgment, makes decisions, and works autonomously under a minimal amount of supervision.
• Maintains knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting).
• Organization Expectations, as applicable:
• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
• Partners with patient care giver in care/decision making.
• Communicates in a respective manner.
• Ensures a safe, secure environment.
• Individualizes plan of care to meet patient needs.
• Modifies clinical interventions based on population served.
• Provides patient education based on as assessment of learning needs of patient/care giver.
• Fulfills all organizational requirements.
• Completes all required learning relevant to the role.
• Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
• Fosters a culture of improvement, efficiency and innovative thinking.
• Performs other duties as assigned.

Required Qualifications

• B.S./B.A. in applicable field. Four (4) years of applicable experience may substitute for a Bachelor’s degree.
• 3 years of applicable Revenue Cycle experience
• Epic Resolute Certification(s) in one or more of the following Epic applications within 1 Year
• Resolute Hospital Billing Charging or
• Resolute Professional Billing Claims or
• Resolute Hospital Billing Claims or
• Resolute Professional Billing Charging

Preferred Qualifications

• B.S./B.A. in Business Administration, Health Care Administration, or applicable healthcare field.
• 5 years of applicable Revenue Cycle experience
• Registered Health Info Tech or
• Registered Health Info Admin or
• CHRI, or
• Certified Coding Specialist or
• CPC
• Epic Certification in Resolute Professional Billing or
• Epic Resolute Hospital Billing Charging

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.

Salary : $76,211 - $107,598