Senior Analyst, Rev Integrity

Northwestern Medicine - Warrenville, IL

Full-time

Remote - Warrenville, IL

Hospitals

About the position

The Senior Analyst, Revenue Integrity at Northwestern Medicine plays a crucial role in supporting the Clinical Department and revenue cycle by performing charge capture analysis and maintaining compliance within the charge master. This position is responsible for ensuring accuracy and consistency in financial operations, preparing analyses for management, and leading audits to enhance revenue integrity.

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Proactively identify charge capture opportunities in all revenue producing departments.
• Research and interpret billing and coding regulations, communicate to impacted areas, and apply changes that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Lead quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy.
• Lead complex audits and prepare methodology for annual pricing changes and/or annual coding changes.
• Consistently deliver concrete, relevant results.
• Display qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving.
• Troubleshoot complex account errors and provide education for resolution to Revenue Manager(s).
• Resolve and answer questions related to charge capture and complex regulatory billing issues.
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Research, compile, and analyze financial data while organizing and maintaining database files for financial modeling.
• Mentor and support members of Revenue Integrity Team as an informal leader.
• Lead efforts to assess, modify, and/or develop and implement more timely and consistent processes/systems to increase efficiency, accuracy, and meaningfulness of information.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, adopting and implementing industry best practices, and participating in professional societies.
• Support the finance, operations and revenue cycle teams through special projects.
• Protect operations by keeping financial and patient information confidential.

Requirements

• Bachelor's Degree in Business or related field or 10 years of equivalent experience with progressive advancement.
• Strong communication, collaboration, and analytical skills.
• Proficiency with Microsoft office suite.
• 5+ years in revenue cycle or revenue integrity role.
• Requires critical thinking, decisive judgment, high attention to detail and ability to work with minimal supervision.
• Advanced understanding of CPT, HCPCS, ICD-10, and third party billing requirements.
• Extensive knowledge and experience with Medicare/Medicaid regulations.

Nice-to-haves

• EPIC Certification (Resolute Charge Capture)
• EPIC Certification (Clarity Report Data)
• Master's degree in Healthcare Management, Business, MIS, Data Analytics, or related field.
• Beginner to Moderate knowledge of SQL and relational databases.
• RHIA preferred or related health care credential (e.g. Radiology technician, RN)