Revenue Integrity Analyst
Texas Children's Hospital
Bellaire, TX 77401
Description
We’re looking for a Revenue Integrity Analyst, someone who’s ready to grow with our company. In this position you will lead, manage, and/or participate in all Revenue Integrity related projects as assigned by the Director. This incumbent is also responsible for leading and/or supervising initiatives to improve or optimize efficiency while serving both internal and external customers.
Think you’ve got what it takes?
Job Duties & Responsibilities
- Edit and exception resolution. Resolves or coordinates the resolution of charge session edits including DNB, revenue guardian edits, denials, and audits on a timely basis.
- Apply coding, payer and charge capture conventions to compliantly resolve edits
- Identifies opportunities for capturing additional revenue in accordance with payer guidelines
- Keeps edits and exceptions within targets as assigned by leadership
- Coordinates efforts for resolution with all Revenue Cycle Departments as appropriate
- Communicates with clinical departments, when needed, to assist in edit resolution
- Evaluates edits to determine potential opportunities for automated resolution
- Maintains high productivity and quality with minimal supervision over assigned work queues
- Develops measures to track, trend, and monitor charge sessions and account resolutions, including audits and denials.
- Provides consistent and clear feedback to the Revenue Integrity Team, Revenue Cycle Counterparts, and Hospital Operations and Providers
- Track and trend defense audits
- Identify and monitor departments with charge capture and denial issues and develop processes for improvement.
- Serve as the contact and advocate to assigned Service Line leadership for all revenue cycle processes and workflows.
Skills & Requirements
- Required High School Diploma or GED HSD must be accompanied by a certification or bachelor's degree
- Required one of the following certifications:
- CHRI - Certified Healthcare Revenue Integrity Professional by the National Association of Healthcare Revenue Integrity (NAHRI)
- CRCR - Certified Revenue Cycle Representative by the Healthcare Financial Management Association (HFMA)
- CHFP - Certified Healthcare Financial Professional by the Healthcare Financial Management Association (HFMA)
- CSAF - Certified Specialist Accounting & Finance by the Healthcare Financial Management Association (HFMA)
- CPC - Cert-Cert Professional Coder by the American Academy of Professional Coders (AAPC)
- RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)
- RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)
- CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
- CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
- COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
- Required 4 years Revenue Cycle experience, including but not limited to Revenue Integrity, Billing, Coding, Denials, Follow-Up, Patient Accounts, and/or Refunds experience
**Hospital Billing and Coding Background highly desired