Senior Revenue Integrity Analyst

Highmark Health - Springfield, IL

Full-time - Mid Level

Springfield, IL

Insurance Carriers and Related Activities

About the position

The Senior Revenue Integrity Analyst plays a crucial role in providing regulatory guidance and enhancing the Revenue Cycle Center (RCC) operations for facilities and physician practices. This position focuses on optimizing procedures, ensuring compliance, and improving documentation and billing processes. The analyst will collaborate with various stakeholders, including clinical staff and leadership, to identify training needs and enhance workflows within the Revenue Cycle.

Responsibilities

• Act as the primary revenue cycle liaison for complex clinical departments and practices, monitoring charge reconciliation reports to identify trends and compliance issues.
• Perform complete revenue cycle reviews, including Charge Description Master (CDM) audits, ensuring appropriate capture and reporting of revenue and compliance with regulations.
• Lead and participate in complex projects related to revenue cycle initiatives, providing oversight for projects involving Revenue Integrity analysts.
• Collaborate with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit, and other departments on revenue management initiatives.
• Develop and maintain a Quality Audit program and assist in performance audits related to team members' 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.
• Five years of experience in hospital or physician revenue cycle, billing, coding, or billing.
• Experience with electronic health records (EPIC).

Nice-to-haves

• Three years in an Epic-billing environment.
• Three years of experience with a specific emphasis 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
• Flexible scheduling options