Senior Revenue Integrity Analyst

Highmark Health - Boise, ID

Full-time - Mid Level

Boise, ID

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 documentation and billing processes. The analyst will conduct thorough analyses, monitor compliance, and lead initiatives to enhance revenue cycle integrity across clinical departments.

Responsibilities

• Acts as primary revenue cycle liaison for complex clinical departments and practices, monitoring charge reconciliation reports to identify trends and compliance issues.
• Provides guidance, communication, and education on correct capture, coding, and billing processes to multiple clinical departments and practices.
• Performs complete revenue cycle reviews, including Charge Description Master (CDM) audits, focusing on revenue cycle integrity and compliance with payor requirements.
• Leads and participates in complex projects related to revenue cycle initiatives, providing oversight and expertise.

Requirements

• Experience in revenue cycle management and regulatory compliance within healthcare settings.
• Strong analytical skills with the ability to perform root cause analysis and identify trends in revenue cycle processes.
• Excellent communication skills to effectively educate and collaborate with clinical staff and leadership.

Nice-to-haves

• Familiarity with healthcare coding and billing systems.
• Experience with clinical documentation improvement initiatives.

Benefits

• Health insurance coverage
• 401k retirement savings plan
• Paid holidays and vacation time
• Professional development opportunities