Revenue Integrity Analyst

  • University Medical Center of Southern Nevada
  • Las Vegas, NV, USA
  • Jan 05, 2021
Full Time Healthcare IT

Job Description

EMPLOYER PAID PENSION PLAN OF 29.25% OF YOUR ANNUAL SALARY! GENEROUS BENEFITS PACKAGE! THIS POSITION MAY CLOSE WITHOUT NOTICE ONCE A SUFFICIENT NUMBER OF QUALIFIED APPLICATIONS ARE RECEIVED. Position Summary: Maintains the Chargemaster fee schedule in accordance with established coding practices and governmental regulatory requirements. Conducts quality control audits and review charge capture clinical workflows for missed revenue opportunities. Creates action plans for capturing missed revenue. Identifies edits in patient management/billing software that impacts billing accuracy. Ensures CPT, HCPCS and revenue codes are accurate and compliant will all charging and billing guidelines. Serves as a liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build. Job Requirement Education/Experience: Graduation from an accredited school of nursing or equivalent to a Bachelor's Degree in healthcare, finance or a closely related field and three (3) years experience in reviewing hospital charge capture, medical records, clinical charts, regulatory and policy compliance, and/or claims auditing. Licensing/Certification Requirements: Current License by the Nevada State Board of Nursing to Practice as a Registered Nurse, or certification in one of the following: American Health Information Management Association (AHIMA) credentials: Registered Health Information Management Administrator or Technician (RHIA/RHIT), Certified Coding Specialist (CCS). Additional and/or Preferred Position Requirements Recent experience (within the last 5 years) with Epic and Craneware Experience as a Revenue Integrity Analyst in a hospital setting. Ability to teach and train clinicians on "proper" charging methodologies. Knowledge of CPT, HCPCS and revenue codes Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Compliance regulations related to charge capture, clinical documentation, coding, and billing requirements; Epic and Craneware systems; clinical revenue integrity processes and impact through revenue cycle; charge master, coding principles and guidelines including, but not limited to CPT, E&M, HCPCS, code edits, auditing, denials management, documentation improvement and related revenue cycle workflows; auditing concepts and principles; reviewing medical records and coding documents according to standard practice; department and hospital safety practice and procedures; patient rights; age specific patient care practices; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures. Skill in: Developing effective solutions for complex business challenges; leading teams to consensus; developing training materials; reviewing and verifying accuracy of data; reviewing medical records and coding documents according to standard practice; using initiative and independent judgment within general policy guidelines; preparing clear and concise reports, correspondence and other written materials; using computers and related software applications; communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds; establishing and maintaining effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment. Physical Requirements and Working Conditions: Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a VDT screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 20 pounds of force occasionally and/or an eligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification. MPUMCLV #LI-MH1 University Medical Center of Southern Nevada offers a benefits package that leads the market and includes: Employer Paid Pension Plan totaling 29.25% of your annual salary! Vestment in the pension plan after 5 years of qualifying employment! Consolidated Annual Leave (CAL) - CAL is used for personal leave, holidays (eleven scheduled holidays per year), doctor appointments, vacation, and sick days up to 16 consecutive scheduled work hours (short term sick leave), etc. Eligible employees shall accrue CAL at the following rates. Part-time accrual is based on the number of paid benefit hours. Length of Service Rate of Accrual per 80 hours worked Days per year (based on 8-hour day) 0 – 12 months 0-90 days > 3.077 hours* *Upon completion of the 90th day of employment, the employee's CAL bank will be credited with an additional 12 hours. 91 days – 12 months > 5.2769 hours** **Upon completion of the twelfth month of employment the employee's CAL bank will be credited with an additional 80 hours. 27 days 13 months – 48 months 8.3077 hours 27 days Credit Union Eligibility 457 Deferred Compensation Plan Comprehensive Group Health Insurance Plan Nevada has no State Income Tax No Social Security Deduction UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA IS AN AFFIRMATIVE ACTION/ EQUAL OPPORTUNITY EMPLOYER 01 (Edu) What is the highest diploma you have achieved? High School Diploma or GED Associate Degree Bachelor Degree Master Degree Doctorate Degree None of the Above 02 What is the study major your degree in? Select as many as applies. Registered Nurse Healthcare Administration Finance Other (please specify in your application) None of the Above 03 How many years experience do you have in reviewing hospital charge capture, medical records, clinical charts, regulatory and policy compliance, and/or claims auditing? None less than 3 years 3 - less than 5 years 5 - less than 7 years 7 - less than 12 years 12 years and more 04 Please select the certification(s) and/or license that you currently possess. Select as many as applies. Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT) Certified Coding Specialist (CCS) Valid Nevada RN license None of the Above 05 What best will you describe your experience, knowledge, and skills relevant to this position. Select as many as applies. Recent experience (within the last 5 years) with Craneware Recent experience (within the last 5 years) with Epic Experience as a Revenue Integrity Analyst in a hospital setting. Ability to teach and train clinicians on "proper" charging methodologies. Knowledge of CPT, HCPCS and revenue codes None of the Above 06 (All-Req) I understand that my answers to the supplemental questions alone will not qualify me for the position. I must document those experience, level of education, and certifications clearly in the application in order to be qualified. Yes, I understand and will include those experience, level of education, and certifications clearly in the application.

Salary

$70,096.00 - $108,659.20 Annually

Employment Type

Full Time