Revenue Integrity Service Line Analyst - Revenue Integrity - F/T Days

$73,900 - $133,700/Yr

University of California - Orange, CA

Full-time - Mid Level

Orange, CA

Educational Services

About the position

The University of California, Irvine, is seeking a Revenue Integrity Service Line Analyst to join its Revenue Integrity team. This full-time position is based in Irvine, California, and is integral to the financial operations of the medical center. The analyst will work under the direct supervision of the Revenue Integrity Assistant Director, focusing on data collection, report production, and comprehensive financial analysis of hospital information. This role supports the internal operations of Revenue Integrity as well as the broader revenue cycle functions at the organizational level. The analyst will monitor charge capture activities, assist in charge automation initiatives, and collaborate with revenue cycle business partners on programming enhancements and system upgrades. The position requires retrieving data for standard and ad hoc reporting, with analyses that include trending, benchmarking, functional flows, and performance measures to identify deficiencies and improvements in the revenue cycle. The incumbent will serve as the primary liaison for all institutional revenue generation for diagnostic and therapy services, including but not limited to Pathology, Cardiology, Radiology, and Therapy Departments.

Responsibilities

• Writes, reviews, and recommends effective changes to system policies and procedures to ensure appropriate utilization.
• Writes effective analytical reports and descriptive summaries, collecting and assembling analytical and factual data appropriate to assigned problems.
• Maintains information in formats that facilitate reporting needs and support charge practice initiatives, ensuring dissemination of accurate, reliable, timely, accessible, actionable information.
• Performs extensive analysis including benchmarking, trends, and performance improvement needs for revenue integrity functions.
• Conducts internal and external trend analyses and effectively identifies corrective measures as needed.
• Provides comprehensive financial analysis of revenue cycle performance indicators and offers recommendations for improvement of identified deficiencies.
• Monitors daily charge processing and interfaces, resolving issues as they occur.
• Acts as liaison to staff, department managers, PFS, DSS, and HIM for revenue cycle work processes.
• Develops and participates in project plans for systems upgrades and programming enhancements, including objectives, scope, approach, resources, time frames, and targeted outcomes.

Requirements

• Skill to read and correctly interpret governmental and commercial payor regulations and develop and implement recommendations consistent with interpretations.
• Skill to effectively work with all levels of health system personnel including directors and physicians.
• Skill in converting master files into reports for departmental use and in ad hoc technical report writing, complex analysis, and data conversion into different formats.
• Must have a working knowledge of Current Procedural Terminology (CPT) and Diagnosis (ICD-9) codes.
• Knowledge of provider and governmental processes.
• Knowledge of ICD-10 and CPT codes.
• Knowledge of HIPAA regulations.
• Extensive knowledge of split fee billing and hospital outpatient charging and OPPS reimbursement.
• Experience working with hospital billing systems and knowledge of third-party billing requirements, as well as knowledge of institutional and professional charging practice and charge automation functions, typically obtained through 5 years' experience.
• Knowledge of automated patient account functions and familiarity with Electronic Health Records interfaces, extrapolation of data, and charge processing.
• Excellent written and verbal communication skills in English.
• Excellent computer skills and experience with a thorough working knowledge of Microsoft Access and Excel.

Nice-to-haves

• Knowledge of Tableau.
• Knowledge of Structured Query Language (SQL).
• Database experience with SQL.
• Certificate as a CHP professional from AHIMA.
• CPC-H or CPC coding certification.
• Bachelor's Degree in Business, Finance, or related field.

Benefits

• Medical insurance
• Sick and vacation time
• Retirement savings plans
• Access to discounts and perks