Revenue Integrity Analyst

Summary

The Revenue Integrity Analyst position for Professional Billing will be involved in assisting the newly developed Revenue Integrity department in establishing guidelines for internal review processes and workflows. Those processes may include, but are not limited to, the following: Updating Professional Billing Commercial/Government Payer contracts, establishing a variance workflow to capture under payments and assuring through contract review that our contracts loaded in the Epic system are calculating based on contract language expected reimbursement amounts. Assisting as a back-up to our Charge and Credentialing teams with review of potential charge and/or credentialing WQs, Charge Audits, and System Issue identification. Must possess a positive can-do-attitude, be a dependable collaborator, have optimal organization and documentation skills. Professional communication ability required both verbally and written. Experience with Professional Billing, Coding and Reimbursement and Payer Contracts is a plus. A firm understanding of our governmental payers such as Medicare and Medicaid is a necessity.

Requirements

Educational Requirements

Degree/Diploma Obtained

Program of Study

Required/

Preferred

and/or

High School Diploma or Equivalent

Required

Additional Requirements

Prefer Bachelor Degree or higher formal education, 2 years formal education post high school in clinical, financial, or coding program.

Experience Requirements

Minimum Years Required

Area of Experience

Required/

Preferred

and/or

3 Years

Healthcare

Required

Additional Requirements

3 experience in healthcare-related field, in hospital billing, coding and/or charging/reimbursement-related capacity. Additional clinical experience in related field a plus.

State of Florida Licensure Requirements

Licenses

Required/

Preferred

and/or

Not Required

Certifications/Registration Requirements

Certificates/Registrations

Required/

Preferred

and/or

Additional Requirements

Coding certification preferred to include CPT, HCPCS, ICD9-10, and DRG