Revenue Integrity Analyst

HPI is hiring a Full Time Revenue Integrity Analyst!

We’re offering an exciting opportunity to work alongside a dedicated, compassionate team – where you are valued just as much as the patients we serve. At HPI, we are guided by our C.A.R.E.S. values where Compassion is required, Attitude is valued, Respect is demanded, Excellence is expected and Service is commended. Come be a part of a place where your hard work is recognized, your goals are supported, and your impact matters.

What We Offer

As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes:

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short- and long-term disability
• Flexible financial benefits including FSAs, HSAs, and Daycare FSA.
• 401(k) and access to retirement planning
• Employee Assistance Program (EAP)
• Paid holidays and vacation

A revenue integrity analyst in a healthcare organization is responsible for ensuring the accuracy and compliance of billing, coding, and charge capture processes to optimize revenue and minimize financial risk. They perform audits, analyze denial data, collaborate with clinical and finance teams, and develop reports to identify and address issues that impact the organization's financial health.

Key Responsibilities:

• Audits and Analysis: Conduct internal billing audits, perform quantitative and financial analysis, and analyze denial trends to identify root causes.
• Compliance: Ensure adherence to managed care contracts, government fee schedules, and other healthcare regulations.
• Charge Master Management: Manage and maintain the charge master, which is a list of services and procedures a healthcare facility charges for.
• Reporting and Trending: Develop and produce standard and ad-hoc reports to track revenue cycle performance, reimbursement trends, and key performance indicators.
• Process Improvement: Collaborate with clinical, operational, and finance teams to implement process improvements, workflow changes, and system enhancements.
• Education and Training: Provide education and training to employees and provider offices on correct claim coding and billing procedures. 

Essential Functions:

• Must possess effective and efficient communication, computer, phone and Microsoft Office skills.
• Epic hospital system knowledge and experience is recommended.
• Must be able to interpret various charge correction requests, determine their validity and perform necessary actions.
• Must be able to recognize and address claim issues encountered through AR billing system and/or Epic.
• Must maintain a positive working relationship with any and all entities they may come in contact with on a daily basis. This includes, but not limited to, clients, physicians, payers, co-workers, management and customers.
• Must be able to handle stressful situations, multi-task a variety of responsibilities and work under strict timelines.
• Employee is expected to be proficient in all systems, programs and processes associated with their current position within the facilities.
• Responsible for the upkeep of charge master files. These duties include, but are not limited to the addition of new charge/procedure/CPT codes.
• Expected to stay up to date on coding, billing and insurance regulations to ensure our claims are filed correctly as to not delay or reduce reimbursement.
• Effectively working and cooperating with supervisors, co-workers and clients.
• Following the directions of supervisors.
• Ability to work independently, with little supervision, and as a team.
• Performs other duties as assigned.

Functional Accountabilities:

• Identifies all charge entry errors through electronic claims submission rejections, return reports and denials.
• Researches and identifies the charge entry errors and makes all necessary corrections to resolve the issue.
• Receives charge entry correction requests from department managers and performs necessary research to verify the requested correction as valid.  After verified makes all necessary corrections to claim.
• Responds to client requests within 1 business day to advice correction completed or communicates expected turnaround time if completion will take longer.
• Completes requests for master file revisions received from team members and management.
• Reviews master files to make sure their set up is complete and all the information is correct as entered.
• Tracks errors by doctor/client, error type and correction made so that this information can be reported to management for training of appropriate staff.
• Establishes and maintains a professional working relationship with all clinics/staff in all manners of communication.
• Assist manager with special projects and/or reports created for clients/staff.
• Works assigned work queues to completion daily.
• Reports all trends identified through researching errors so that they may be addressed and corrected to reduce delays in claim processing.
• Reviews current accounts for charging accuracy prior to claims being billed.

 Qualifications:

• High School Diploma or equivalent Required
• Bachelor’s Degree in a related field is preferred with licensure (CCS, RHIA, RHIT)
• Minimum 2 years of related experience
• Epic electronic health record (EHR) experience preferred
• Proficiency in Microsoft Office preferred.