Revenue Integrity Analyst

Job Type
Full-time
Description
Who We Are:
As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175+ providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a not-for-profit, non-tax-supported group practice and is here to serve the community while providing medical excellence to our patients.
Position Summary:
Under the direction of the Director of Revenue Cycle, the Revenue Integrity Analyst will provide analytical support to proactively identify performance trends and propose solutions when needed.
Responsible for determining and identifying variations in daily total charges across all revenue generating departments. Monitors daily ancillary charge report to identify potential charging issue related to system failures, system updates or other. Reviews denial trends for documentation and charging opportunities. Serves as a liaison between Revenue Services and Operational departments regarding total charge variations and revenue opportunities.
A key responsibility of this role will be leading projects and assessments prioritized by department leadership. As part of ensuring operational integrity of the revenue cycle processes, the position executes steps that support the maintenance and enhancement of all revenue cycle systems.
Key Results Areas (KRAs):

• Monitors charge capture across all clinical charging departments. Ensures department charge review and reconciliation is performed on a daily basis to prevent lost revenue. Plays key role in developing reconciliation policies.
• Oversees charging practices and maintains collaborative relationships across UCH in order to serve as a bridge between clinical, financial, IT, compliance, revenue services, and Baptist One Care teams within the EPIC environment.
• Performs root cause analysis on identified total charge variations and collaborates with the Revenue Services and/or Operations to resolve identified issue.
• Monitors total charges associated with new service lines, procedures and/or systems to ensure charges are crossing through the various systems to ensure payment.
• Communicate and coordinate resolution of identified issues with charge capture, denials, payment variances and contract operations to leadership and other stakeholders. Provide prompt responses to issues, issues, concerns, and/or complaints.
• Documents department workflow and assists periodic assessments to ensure efficient processes.
• Tracks WQ performance to ensure timely processing of claims and proactive identification of billing issues.
• Assists with charge master maintenance, including annual updates to ensure appropriate billings and maximization of revenue.
• Performs and assists with activities related to department rounding, workflow review, education/training, issue identification, root cause analysis, and system updates needed for complete and accurate clinical department charge entry. Provides feedback to assist management in developing strategies to improve patient financial service operations.
• Creates a positive, constructive, and supportive relationship between departments, external partners, and personnel needed to resolve issues.

Requirements
Requirements:

• Bachelor's degree or equivalent experience required, Masters Preferred.
• 3 to 5 years of healthcare experience required, including full scope revenue cycle.
• Self-starter with broad revenue cycle experience and knowledge, including but not limited to insurance reimbursement policies, CPT & ICD-10 coding, payer contracting, operations and billing regulations.
• Strong critical thinking, communication, and interpersonal skills. Demonstrated ability to work collaboratively with stakeholders across multiple departments.
• Extensive background working with MS Office, with an advanced Excel skill.
• Epic experience preferred

EOE-University Clinical Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws. University Clinical Health is a VEVRAA Federal Contractor - priority referral Protected Veterans requested.