Senior Revenue Integrity Analyst

Highmark Health - Augusta, ME

Full-time - Mid Level

Augusta, ME

Insurance Carriers and Related Activities

About the position

The Senior Revenue Integrity Analyst at Highmark Health plays a crucial role in providing regulatory guidance and enhancing the Revenue Cycle Center (RCC) operations. This position focuses on optimizing procedures, ensuring compliance, and collaborating with various stakeholders to improve clinical documentation and billing processes. The analyst will conduct thorough revenue cycle reviews, lead complex projects, and develop training materials to support the organization's revenue management initiatives.

Responsibilities

• Acts as primary revenue cycle liaison for complex clinical departments and practices, monitoring charge reconciliation reports to identify trends and compliance issues.
• Performs complete revenue cycle reviews, including Charge Description Master (CDM) audits, to ensure appropriate revenue capture and compliance with regulations.
• Leads and participates in complex projects related to revenue cycle initiatives, overseeing the involvement of Revenue Integrity analysts.
• Collaborates with various departments on revenue management initiatives, including Compliance, Budget Office, and Patient Accounts.
• Develops and maintains a Quality Audit program and assists in performance audits related to team members' 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 related fields.
• 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