Revenue Integrity Analyst

Beth Israel Lahey Health - Boston, MA

Full-time - Mid Level

Boston, MA

10,001+ employees

Hospitals

About the position

The Revenue Integrity Analyst plays a crucial role in ensuring accurate revenue capture and billing processes within the healthcare system. Reporting to the Director or Manager of Revenue Integrity, this position serves as a primary contact for various stakeholders, including service line directors, finance directors, and clinical staff. The analyst is responsible for educating team members on billing practices, implementing new procedures, and enhancing workflows to maximize revenue capture while adhering to regulatory standards.

Responsibilities

• Provide comprehensive Revenue Cycle support for professional service staff and hospital facilities.
• Represent PFS at interdepartmental and finance meetings to evaluate charge capture workflows.
• Analyze and draft internal controls to comply with changes in government and payer policies.
• Monitor and analyze revenue and late charge reports to identify trends and improve workflows.
• Collaborate with Epic system analysts on revenue cycle software upgrades and implementations.
• Produce and maintain reporting mechanisms detailing departmental productivity and revenue capture initiatives.
• Stay updated on new services to maximize revenue capture and perform internal audits.
• Participate in the development and maintenance of electronic systems for revenue capture.
• Keep abreast of coding, billing, and reimbursement rules related to revenue capture.
• Engage in complex projects and audits related to revenue initiatives and fraudulent billing investigations.
• Develop and report monthly and annual statistical data aligned with KPIs.
• Identify problems or opportunities for improvement in clinical orders and documentation.

Requirements

• Associates Degree in business or finance, or 4 additional years of healthcare revenue cycle experience in lieu of a degree.
• Minimum 2 years of healthcare revenue cycle experience.
• Epic proficiency or certification in Charge Description Master.
• Comprehensive knowledge of medical/hospital billing practices and CMS regulations.
• Knowledge of CPT, HCPCS, and ICD-10 coding principles.
• Familiarity with Epic or related hospital ADT/Billing software.
• Proficient in data entry and various electronic systems.
• Ability to read and interpret financial reports.
• Strong problem-solving and analytical skills.
• Excellent organizational and multitasking abilities.
• Proficient in Excel.

Benefits

• Health insurance coverage
• Paid time off
• Retirement savings plan
• Professional development opportunities
• Employee wellness programs