St Paul, Minnesota, USA
3 days ago
Revenue Integrity Charge Description Master Analyst
Overview Fairview is offering a great opportunity for a Revenue Intergrity Charge Description Master Analyst. Here are some key points about the position: Location: University of MN Medical Center East Bank Hospital, Minneapolis, MN Position: Remote FTE: 1.0 (80 hours per pay period) Shift: day shift with no weekends required Benefits: Medical Insurance: As low as $0 Dental Insurance: As low as $0 PTO: 24 days per year Retirement Plan: 403B with up to a 6% employer match Compensation: Wages: Starting at $35.93/hr, increasing with experience Hiring Process: A video interview may be required, allowing candidates to showcase themselves and their interest in the position. For more details on benefits, you can visit www.fairview.org/benefits. Responsibilities Job Description Job Summary: 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. Job Expectations: 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). Qualifications Required Education Bachelor’s degree in applicable field. Four (4) years of applicable experience may substitute for a Bachelor’s degree. Experience 3 years of applicable Revenue Cycle experience License/Certification/Registration Epic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing Charging, Resolute Hospital Billing Charging, Resolute Professional Billing Claims, Resolute Hospital Billing Claims, OR ability to obtain certification within one year of hire. Preferred Education Bachelor’s Degree in Business Administration, Health Care Administration, or applicable healthcare field. Experience 5 years of applicable Revenue Cycle experience License/Certification/Registration RHIA, RHIT, CHRI, CCS, or CPC certification. Epic Certification in Resolute Professional Billing or Epic Resolute Hospital Billing Charging EEO Statement EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
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