Sr. Revenue Integrity Analyst

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Provides subject matter expertise in reviewing and analyzing revenue optimization and reconciliation processes. Identifies and resolves issues while working with Revenue Cycle departments to ensure accurate and compliant revenue capture.

Job Requirements:

Education and Work Experience:

• Associate's/Technical Degree or equivalent combination of education/related experience: Required
• Bachelor's Degree: Preferred
• Five years' relevant experience: Preferred
• Three years' revenue cycle billing/collections/reimbursement experience or managed care contracting experience: Preferred

Licenses/Certifications:

• Certified Revenue Cycle Representative (CRCR) Certification: Preferred

Essential Functions:

• Interprets insurance contracts, government regulations and other non-contracted reimbursement methods to implement and maintain a reimbursement system which accurately calculates expected payments and contractual adjustments from all payers at one or more entities
• Establishes and organizes a systematic transparent revenue integrity audit and improves processes with ongoing tracking, metrics and reporting that demonstrates progress.
• Analyzes payment/contractual adjustment/other system variances and performs detailed reimbursement review to decide whether corrective action is required within the reimbursement system, other revenue cycle departments, and/or with the payer.
• Collaborates with Revenue Cycle departments on contract, revenue cycle and payer practice issues in order to increase revenue integrity.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 90 communities on the West Coast and Hawaii with over 400 sites of care, including 26 acute care facilities, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.