Senior Revenue Integrity Analyst

Highmark Health - Boston, MA

Full-time - Mid Level

Boston, MA

Insurance Carriers and Related Activities

About the position

The Revenue Cycle Liaison position at Allegheny Health Network is responsible for providing practice and regulatory guidance to enhance the Revenue Cycle Center (RCC) operations. This role involves optimizing end-to-end procedures, ensuring compliance, and collaborating with various stakeholders to improve clinical documentation and billing processes. The incumbent will analyze revenue cycle performance, conduct audits, and lead initiatives to maintain revenue integrity across clinical departments.

Responsibilities

• Act as primary revenue cycle liaison for complex clinical departments, monitoring charge reconciliation reports and identifying trends.
• Perform complete revenue cycle reviews, including audits of Charge Description Master (CDM) to ensure compliance and revenue integrity.
• Lead and participate in complex projects related to revenue cycle initiatives, overseeing the involvement of Revenue Integrity analysts.
• Collaborate with various departments on revenue management initiatives, including Compliance and Internal Audit.
• Develop and maintain a Quality Audit program, assisting in performance audits related to identified areas of opportunity.

Requirements

• Bachelor's Degree in Business, Healthcare, or related field, or six years of related experience in lieu of a degree.
• 5 years of experience in hospital or physician revenue cycle, billing, coding, or billing.
• Experience with electronic health records (EPIC).

Nice-to-haves

• 3 years of experience in an Epic-billing environment.
• 3 years of experience with a focus on regulatory issues and policy development, with advanced knowledge of healthcare regulatory policies.

Benefits

• Health insurance coverage
• Dental insurance coverage
• Vision insurance coverage
• 401k retirement savings plan
• Paid holidays
• Paid time off (PTO)
• Flexible scheduling options