Address
Form of workThe Revenue Integrity Analyst is responsible for performing and implementing charge capture and process improvement initiatives to optimize performance and improve revenue management. This position is also responsible for conducting root cause analysis, developing corrective action plans, educating internal customers, and monitoring results. This position will collaborate with the Revenue Integrity Team to operationalize Phoenix Children’s Revenue Integrity strategy and plan for improving revenue results across all departments, financial processes, functions, and interdependencies from the provision of patient care to final payments.
Position Duties
- Supports the Revenue Integrity Team and Phoenix Children`s Strategic Revenue Cycle Plan
- Supports the Revenue Integrity Team and Phoenix Children’s strategic Revenue Cycle plan by optimizing processes to ensure services rendered are accurately reported and reimbursed while maintaining compliance with all Federal and State regulations, payer policies, and coding guidelines.
- Collaborates
- Collaborates closely with the Revenue Integrity Team, Compliance, Hospital & Physician Business Offices, Transplant Revenue Cycle, Health Information Management (HIM), Information Technology (IT), Managed Care, and Finance to facilitate proper coding and billing outcomes.
- Supports Denials Governance Committee
- Supports the Denials Governance Committee, focusing on denial prevention activities and performance improvement.
- Develops Standardized Charge Capture Processes
- Develops standardized charge capture processes including daily reconciliation and reporting for all clinical departments.
- Performs Root Cause Analysis
- Performs root cause analysis resulting from charge capture reconciliation, audits, and the CDM to resolve payor denials, coding/billing edits, and/or other delays or reductions to cash flow.
- Implements Process Improvements
- Implements process improvement strategies designed to streamline workflow, automate, and optimize technologies.
- Provides Focused Education
- Provides focused education to clinical and coding stakeholders and best practice recommendations for improvement.
- Develops Standardized Reporting
- Develops standardized reporting for both leadership and clinical departments including a dashboard of financial activity that is meaningful to the end user.
- Monitors Key Performance Indicators
- Monitors Key Performance Indicators (KPIs) to identify new Revenue Integrity initiatives, track performance improvement activities, recognize important trends that may impact revenue (cause and effect), and document improved performance.
- Conducts Audits
- Conducts post-implementation audits to ensure that system updates and CDM changes result in appropriate reimbursement.
- Assist with Validating Annual Pricing Updates to CDM
- Assists with validating annual pricing updates to the CDM to ensure accuracy and to optimize reimbursement within Phoenix Children’s budget requirements.
- Quantifies Metrics
- Quantifies metrics resulting from improvements made by the Revenue Integrity Team such as incremental revenue, cost savings, CDM compliance, etc.
- Performs miscellaneous job related duties as requested.
Phoenix Children's Mission, Vision, & Values
To advance hope, healing and the best healthcare for children and their families
VisionPhoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.
We realize this vision by:
- Offering the most comprehensive care across ages, communities and specialties
- Investing in innovative research, including emerging treatments, tools and technologies
- Advancing education and training to shape the next generation of clinical leaders
- Advocating for the health and well-being of children and families
- We place children and families at the center of all we do
- We deliver exceptional care, every day and in every way
- We collaborate with colleagues, partners and communities to amplify our impact
- We set the standards of pediatric healthcare today, and innovate for the future
- We are accountable for making the highest quality care accessible and affordable
