Senior Revenue Integrity Analyst

Highmark Health - Montpelier, VT

Full-time - Senior

Montpelier, VT

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, 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 Revenue Integrity and CDM Management policies and training materials.
• 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' identified 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 related fields.
• 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
• Dental insurance
• Vision insurance
• 401k plan
• Paid holidays
• Paid time off (PTO)
• Flexible scheduling