Revenue Integrity Analyst I

This position is responsible for monitoring, identifying, correcting, and analysis of account errors prior to claim submission.

• Supports UHHS clinical areas, new/existing service lines and departments (this includes Revenue Cycle Management) as follows:
  • Assist in daily resolution of billing edits/errors that are holding revenue, by reviewing the medical records and other applicable documentation.
  • Expected to identify, report, and participate in the resolution of any potential or actual revenue/charge related issues.
  • Reviews patient records and can assist with account fixes, charge reconciliation for other departments based on clinical documentation.
  • Responds to departmental charging inquiries timely and seeks guidance when appropriate.
  • Works with Coding and other clinical departments to identify/fix errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.
  • Contributes in the support of quarterly improvement initiatives as directed by department director or manager.
  • Monitors applicable Revenue Integrity KPIs.
  • Assist Revenue Cycle departments with special procedures and various duties as assigned.
  • Success completion of proficiency required to gain access to applicable systems.
• This role requires professional certification maintenance in good standing.

• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

• Technical school (Required) or
• Associate's Degree in finance or science (Required) or
• equivalent combination of education and experience. (Required)

• 1+ years in Healthcare Revenue Cycle, Financial Leadership in a Clinical area or Healthcare Industry Compliance program (Required)

• Demonstrated knowledge of claims submission (UB92's and/or HCFA) or receivables management. (Required proficiency)
• Knowledge of hospital outpatient and/or physician revenue capture knowledge. (Required proficiency)
• Knowledge of ICD Diagnosis, ICD Procedure codes, CPT codes, Revenue codes, and medical terminology. (Required proficiency)
• Detail-oriented and organized, with good analytical and problem-solving ability. (Required proficiency)
• Notable client service, communication, presentation, and relationship building skills. (Required proficiency)
• Ability to function independently and as a team player in a fast-paced environment. (Required proficiency)
• Must have strong written and verbal communication skills. (Required proficiency)
• PC proficiency in MS Office. (Required proficiency)
• Proficiency with VitalWare, Soarian, or Epic is a plus. (Preferred proficiency)

• Certified Coding Specialist (CCS) Applicable professional certification through AHIMA (Required) and
• Registered Health Information Technologist (RHIT) Applicable professional certification through AHIMA (Required) and
• Certified in Infection Control (CIC) Applicable professional certification through AAPC (Preferred) and
• Certified Professional Coder (CPC) Applicable professional certification through AAPC (Preferred) and
• Certified Outpatient Coder (COC) Applicable professional certification through AAPC (Preferred)
• CCA- A