REVENUE INTEGRITY ANALYST

Duke University - Durham, NC

Full-time

Durham, NC

Educational Services

About the position

The position is focused on ensuring accurate coding and documentation within Duke Health's Patient Revenue Management Organization. The role involves monitoring data quality, conducting audits, and providing education to staff and healthcare professionals to optimize reimbursement and compliance with coding standards and regulations.

Responsibilities

• Monitor data quality and optimal reimbursement by performing concurrent and prospective quality reviews for accurate coding and sequencing of diagnoses and procedures.
• Interpret guidelines, applicable laws, and regulations concerning hospital coding and develop specific coding guidelines for inpatient and outpatient care.
• Research problem areas and develop training materials and coding aids for coders, presenting timely education programs regarding coding updates and documentation requirements.
• Identify coding and billing risk areas, conduct focused reviews, and implement corrective actions as needed.
• Serve as a resource on coding and documentation-related issues, educating physicians and healthcare professionals on documentation requirements for accurate coding and reimbursement.
• Collaborate with coding, billing, and other departments for process or system changes and participate in educational initiatives associated with HIM strategies.

Requirements

• Bachelor's degree in business administration, accounting, management, healthcare administration, nursing, or a related degree.
• 3 years of experience related to auditing and/or coding is required.
• Coding certification (e.g., CCS, RHIA, RHIT) or applicable experience is preferred.

Nice-to-haves

• Clinical experience is preferred.

Benefits

• Duke Health is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's background.
• Opportunities for professional development and education.