Revenue Integrity Analyst - Full-Time

Sturdy Health - Attleboro, MA

Full-time - Mid Level

Attleboro, MA

1-10 employees

About the position

The Revenue Integrity/Charge Capture/CDM Analyst is responsible for ensuring the timely and accurate recording of hospital revenue related to charge capture and the maintenance of the charge description master. This role involves collaboration with various departments, including Patient Accounts, Finance, Information Systems, and Compliance, to develop and maintain systems and processes that enhance revenue integrity.

Responsibilities

• Manage the revenue charge capture to ensure efficiency and effectiveness.
• Develop processes and procedures for timely and appropriate capture of chargeable activities.
• Monitor late charges and implement procedures to minimize them.
• Maintain collaborative relationships with revenue-producing departments and technical personnel to identify chargeable activities.
• Develop pricing philosophy and techniques for establishing new fees for supplies and services.
• Manage the hospital's charge description master, ensuring all relevant coding is maintained for billing and reporting.
• Stay updated on federal and state billing regulations and contract provisions in managed care contracts.
• Implement pricing changes as needed and monitor departmental monthly revenue, discussing variances with clinical departments.
• Ensure charge descriptions meet compliance standards, including managing annual CPT and HCPCS code updates.
• Review payments for contract compliance and work with Patient Accounts staff to correct mis-payments.

Requirements

• Bachelor's degree or related experience.
• Two plus years of related experience in a hospital or health system.
• Strong knowledge of medical terminology, clinical procedures (CPT/HCPC), revenue codes, and claims processing.
• Proficiency in Microsoft Word and Excel; experience with Cerner and 3M preferred.
• Strong communication and organizational skills.
• Attention to detail and ability to work independently.

Nice-to-haves

• Master's degree preferred.