Farmington, Connecticut, USA
50 days ago
Revenue Integrity Analyst
Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryThe Revenue Integrity Analyst ndash Level serves as an integral part of both revenue optimization and compliance within the organization through leveraging an integrated Epic based EMR to assist in the identification reporting and resolution of any issues stemming from or with charge capture processes for both hospital and professional outpatient services This role typically services many ndash of the institutes as these areas growing in size technology requiring additional dedicated support as it relates to all elements of the revenue cycle ensuring the financial success of these institutes The role services both the professional and hospital services as it relates to procedural services Through the use of data system reports and analytics this role will support the charge capture and accuracy efforts This position will help to optimize revenue cycle processes by validating evaluating and trending large amount of data for presentation to all levels of the organization This position also serves as technical support for Revenue Integrity staff Revenue Cycle Departments and Clinical areasPosition ResponsibilitiesKey Areas of Responsibility 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 Assesses the accuracy of all charging vehicles including clinical systems and dictionaries encounter forms and other charge documents used to capture revenue Analyzes denial data to identify root causes of preventable denials develop and implement corrective action plans to address root causes including collaborating with the clinical areas as well as other departments within revenue cycle Optimizes revenue cycle processes by validating evaluating and trending large amount of data for presentation to all levels of the organization Performs regular charge audits identifying any trends and implementing corrective actions when appropriate Document findings and corrective actions reporting to the Revenue Integrity Manager Provides guidance communication and education on correct charge capture documentation coding and billing processes Lead annual quarterly CPTreg HCPCS changes for accuracy compliance with applicable billing guidelines and optimization of reimbursement Communicate CDM maintenance activities to clinical departments and information systems staff to implement necessary changes that affect charge identification capture reconciliation and claim processing Ensure changes within the charge description master CDM coincide and are implemented with clinical systems by reviewing flow sheets or charge capture preference lists Monitor national state and local information to keep current with applicable regulatory and legislative changes and tailor the revenue integrity program accordingly Leads and participates in projects and other duties related to revenue cycle initiatives and duties Includes training new analystsWorking RelationshipsThis Job Reports To Job Title Manager Revenue Integrity AnalystWork where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryThe Revenue Integrity Analyst ndash Level serves as an integral part of both revenue optimization and compliance within the organization through leveraging an integrated Epic based EMR to assist in the identification reporting and resolution of any issues stemming from or with charge capture processes for both hospital and professional outpatient services This role typically services many ndash of the institutes as these areas growing in size technology requiring additional dedicated support as it relates to all elements of the revenue cycle ensuring the financial success of these institutes The role services both the professional and hospital services as it relates to procedural services Through the use of data system reports and analytics this role will support the charge capture and accuracy efforts This position will help to optimize revenue cycle processes by validating evaluating and trending large amount of data for presentation to all levels of the organization This position also serves as technical support for Revenue Integrity staff Revenue Cycle Departments and Clinical areasPosition ResponsibilitiesKey Areas of Responsibility 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 Assesses the accuracy of all charging vehicles including clinical systems and dictionaries encounter forms and other charge documents used to capture revenue Analyzes denial data to identify root causes of preventable denials develop and implement corrective action plans to address root causes including collaborating with the clinical areas as well as other departments within revenue cycle Optimizes revenue cycle processes by validating evaluating and trending large amount of data for presentation to all levels of the organization Performs regular charge audits identifying any trends and implementing corrective actions when appropriate Document findings and corrective actions reporting to the Revenue Integrity Manager Provides guidance communication and education on correct charge capture documentation coding and billing processes Lead annual quarterly CPTreg HCPCS changes for accuracy compliance with applicable billing guidelines and optimization of reimbursement Communicate CDM maintenance activities to clinical departments and information systems staff to implement necessary changes that affect charge identification capture reconciliation and claim processing Ensure changes within the charge description master CDM coincide and are implemented with clinical systems by reviewing flow sheets or charge capture preference lists Monitor national state and local information to keep current with applicable regulatory and legislative changes and tailor the revenue integrity program accordingly Leads and participates in projects and other duties related to revenue cycle initiatives and duties Includes training new analystsWorking RelationshipsThis Job Reports To Job Title Manager Revenue Integrity AnalystEducationMinimum Bachelorrsquos Degree or equivalent Healthcare experience of yrsPreferred Associates degree with health management or financial emphasis andor health services or ten years of healthcare work experienceExperienceMinimum Three to four years of progressive on the job experience in an acute care hospitalPreferred Five years in hospital based health care setting with experience in facility revenue cycle operations Licensure Certification RegistrationCertified Coder CCS CPC etcLanguage SkillsEnglish Strong written and verbal communication skillsKnowledge Skills and Ability RequirementsExtensive knowledge ofmiddot ICD CM diagnostic and CPTHCPCS procedure codesmiddot Clinical information related to responsibility areasmiddot Microsoft Office Products Word ExcelSkillsmiddot Read write and speak English proficientlymiddot Strong analytical capabilitiesmiddot Excellent organizational skillsmiddot Proficiently read and interpret physician writingStrong ability tomiddot Function independentlymiddot Handle multiple prioritiesmiddot Listen and acknowledge ideas and expressions of others attentivelymiddot Converse clearly using appropriate verbal and body languagemiddot Collaborate with others to achieve a common goal through mutual cooperationmiddot Influence others for positive and productive outcomesmiddot Utilize coding subject matter expertise to support new specialized coders and other projectsmiddot Work across the Hartford HealthCare SystemWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentEducationMinimum Bachelorrsquos Degree or equivalent Healthcare experience of yrsPreferred Associates degree with health management or financial emphasis andor health services or ten years of healthcare work experienceExperienceMinimum Three to four years of progressive on the job experience in an acute care hospitalPreferred Five years in hospital based health care setting with experience in facility revenue cycle operations Licensure Certification RegistrationCertified Coder CCS CPC etcLanguage SkillsEnglish Strong written and verbal communication skillsKnowledge Skills and Ability RequirementsExtensive knowledge ofmiddot ICD CM diagnostic and CPTHCPCS procedure codesmiddot Clinical information related to responsibility areasmiddot Microsoft Office Products Word ExcelSkillsmiddot Read write and speak English proficientlymiddot Strong analytical capabilitiesmiddot Excellent organizational skillsmiddot Proficiently read and interpret physician writingStrong ability tomiddot Function independentlymiddot Handle multiple prioritiesmiddot Listen and acknowledge ideas and expressions of others attentivelymiddot Converse clearly using appropriate verbal and body languagemiddot Collaborate with others to achieve a common goal through mutual cooperationmiddot Influence others for positive and productive outcomesmiddot Utilize coding subject matter expertise to support new specialized coders and other projectsmiddot Work across the Hartford HealthCare SystemWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment
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