Revenue Integrity Coordinator II (Charge Analyst) - Remote

Hours: 40 hours per week; Monday through Friday from 8-4:30 PM EST

Location: Fully Remote

Job Profile Summary 

​ This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.  In addition, this role focuses on performing the following Revenue Integrity duties: Responsible for compliantly maximizing financial reimbursement for clinical services provided to patients. Identifies financial reimbursement degradation, maintaining fee schedules, etc.  An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment.  The majority of time is spent in the delivery of support services or activities, typically under supervision.  An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.  Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation. 

Job Overview 

This position is responsible for charge creation and pricing, understanding charge capture methodologies available in Epic, charge compliance with intent of service and correct coding, charge reconciliation workflows and training, periodic regulatory and coding changes and updates, charge capture and billing error review and root cause analysis, collaboration with front and back end revenue cycle operations to understand denials and variances to ensure charge build and charge capture processes, and methodologies are aligned with payer expectations.

Job Description 

Minimum Qualifications: 

1. Bachelor’s degree in Business, Healthcare, or closely related field OR Three (3) years of healthcare experience in lieu of Bachelor's Degree. 

2. Five (5) years of experience in Revenue Cycle including extensive knowledge of revenue cycle processes, hospital/medical billing (CDM, UB, RAs and 1500), Code data sets (CPT, HCPCS, and ICD), NCCI edits, and Medicare LCD/NCDs, and reimbursement standards (DRG, OPPS, HCC, and managed care). 

Preferred Qualifications: 

1. Applicable Certifications: CPC, CCS, CHRI, CRCR, Epic Revenue Integrity/Chargemaster. 

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list.  Other duties and responsibilities may be assigned. 

1. Develops relationships with key stakeholders to develop trust that facilitates influence.

2. Learns and understands services provided to patients.

3. Educates key stakeholders on charge compliance, correct coding, and intent of service of charges.

4. Regularly reviews established charge codes to ensure accuracy and compliance.

5. Creates new charge codes with accurate and payer specific default and alternate coding combinations to ensure maximum reimbursement.

6. Develops charge capture reconciliation processes in collaboration with key stakeholders. 7. Maintains a supportive role with charge reconciliation for key stakeholders.

8. Reviews charge capture workflows and works with the appropriate teams to adjust methods and processes to reduce charge errors improve clean claims.

9. Monitors revenue routing to ensure revenue is aligned with expenses.

10. Analyzes charge errors to determine root cause.

11. Prepares departmental summaries that pinpoint root causes of charge/billing errors and conceptualize process changes for