Senior Revenue Integrity Analyst

Highmark Health

Full-time - Mid Level

Remote

Insurance Carriers and Related Activities

About the position

The Senior Revenue Integrity Analyst position at Allegheny Health Network focuses on providing regulatory guidance and enhancing the Revenue Cycle Center (RCC) operations. The role involves optimizing procedures, conducting analysis, monitoring compliance, and collaborating with various stakeholders to ensure accurate documentation and billing processes. The analyst will also lead projects related to revenue cycle initiatives and develop training materials to support compliance and operational efficiency.

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, ensuring appropriate capture and reporting of revenue and compliance with regulations.
• Leads and participates in complex projects related to revenue cycle initiatives, providing oversight for projects involving Revenue Integrity analysts.
• Collaborates with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit, and other departments on revenue management initiatives.
• Develops and maintains a Quality Audit program and assists in performance of quality audits related to team members' areas of opportunity.

Requirements

• Bachelor's Degree in Business, Healthcare or related field OR six (6) years of related experience in lieu of 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 in an Epic-billing environment.
• 3 years with specific emphasis on regulatory issue and policy development, 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