Under the direction of the Revenue Integrity Director, this position is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection. This position is responsible to discover revenue issue root cause and to develop correction action plan and provide charge capture education. In addition, recommend modifications to established practices and procedures or system functionality as needed to support revenue cycle and manage implementation of the recommended changes. The Revenue Integrity Analyst will work with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and to achieve revenue cycles financial goals.
Acts as liaison between physician practices and coding to provide oversight and communicate provider charge capture performance. Closely aligns with physician coding to support the physician practice in achieving a healthy revenue stream. Partners with Coding, Cerner Clinical Informatics and Revenue Cycle teams to ensure an uninterrupted revenue cycle and support performance improvement opportunities.
Partners with physician practice leaders to provide oversight on open encounters and unsigned orders for a positive impact on timeliness of charges and ultimately the revenue cycle. Ensures new lines of service are communicated and set up proactively. Coordinates department requested CDM charge additions and deletions as applicable.
Identifies areas of risks and opportunities to improve compliance and revenue management. Monitors and resolves audit work queues, proactively identifies revenue opportunity and suggests improvements. Maintains knowledge of current coding and documentation requirements as required for compliant billing.
Collaborates with Clinical Informatics to provide feedback, training and education to providers regarding standardized charge capture workflows. Develops automated processes to replace manual workflow when able.
Provides guidance and education to departments as a subject matter expert on compliant charge capture and charge reconciliation. Provides revenue integrity training to new practice leaders and on an ongoing basis to ensure charge reconciliation procedures are being followed, assisting the practice leader with issue management and resolution.
Collaborates with Revenue Integrity Director to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics. Analyzes and quantifies analytics dashboard results. Prepares timely and accurate reports for presentation to departments, senior leadership, Revenue Integrity and Continuous Improvement forums to support prevention of lost revenue. Escalates variances and collaborates with stakeholders for resolution and process improvement as indicated.
Reviews charging performance against standards and trends. Works with stakeholders to identify root cause and implement solution to remediate charge capture issues. Works with a variety of departments including senior leadership, physician practice, finance, coding, and revenue cycle to assist with data gathering and/or interpretation. Ensures the integrity of reports and databases used for Revenue Integrity.
Provides support for special projects assigned to the department by management for analysis. Brings strength in logic and analysis of data, sorts through data and determines which elements are pertinent to the project. Identifies and recognizes trends, presents data and analysis results to appropriate parties.
Requires a Bachelors degree in Business, Finance, Health Management or related field or equivalent experience.
Requires a proficiency level typically attained with 3-5 years of experience in healthcare related work in a clinical, medical office or acute care setting. Must be knowledgeable of medical terminology and current regulatory agency requirements for coding and have a good understanding of reimbursement methodologies. Must have excellent analytical and organizational skills and the ability to manage multiple priorities with changing needs and deadlines. Requires excellent human relations skills and the ability to effectively interact and communicate both verbally and in writing with all levels staff and outside professionals.
Requires strong abilities in analysis, data interpretation, computer software applications, database and spreadsheet programs, plus a proficiency in generating management reports, projections, allocations, and analyses.
Additional related education and/or experience preferred.
Internal Number: 247427
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.