Revenue Integrity Analyst - remote

Description

Job Description

PeaceHealth is seeking a Revenue Integrity Analyst - Commercial Billing for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $28.02 – $42.04. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Support Payor Relations and Revenue Assurance departments through provisioning of payor contracts, financial analysis and coordination of IT assets; coordinates use of database.

Details of the Position:

• Analyze billing data for correctness and insurance denials to determine errors that are systemic in nature as a means to flag issues for process improvement; queries, pulls and evaluates financial and billing information; evaluates charge code requests to determine their validity and indicates to department leader any issues and proposed modifications prior to forwarding for finalization.
• Act as the CodeCorrect system coordinator for all Clinical Managers; grant levels of access to end users, develops process routes, redefines operational parameters and processing/authenticating transactions; act as primary liaison with Med Assets and is responsible for modifying the product to meet Southwest end user's needs; update the McKesson SIM/FIM tables in STAR.
• Update payor contracts with new rates in IP Pricer; substantiates and validates new price schedules through the use of manual pricer and by writing complex Excel formulas to validate findings; use actuarial files to compare and validate different payor contracts and deduce price variations; construct custom equations and performs error checks; estimates and forecasts price increases to payor contracts for the coming years; conducts other tests to find inconsistencies within the IP Pricer and correct registry errors.
• Perform one-on-one or group training with clinical leaders on CodeCorrect system; process requests and provides education to end users as system or technical questions arise over the use of the system; design training materials and education links.
• Effectively communicate by: interpreting and conveying information clearly and accurately; establishing and maintaining open, effective communications between customers and staff; keeping abreast of and complying with departmental and organizational changes and events through reading posted communications and attending unit and assigned meetings.
• Performs other duties as assigned.
  
  

What You Bring:

Education

• Bachelor's Degree Required: Business or
• Bachelor's Degree Required: Economics or
• Bachelor's Degree Required: Finance or equivalent combination of education and experience
  
  

Experience

• Minimum of 1 year Required: Hospital billing and/or insurance payment verification or equivalent education and/or experience
  
  

Skills

• Strong oral, written and interpersonal communication skills (Required)
• Excellent attention to detail with strong analytical and problem solving skills (Required)
• Advanced computer skills to include Excel, Word, and knowledge of software for hospital contract and/or claims management (Required)
• Ability to accurately run reports and analyze data; ability to navigate multiple software sites simultaneously (Required)
• Ability to work autonomously or as part of a team (Required)
  
  

Working Conditions

Lifting

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.
  
  

Environmental Conditions

• Predominantly operates in an office environment.
  
  

Mental/Visual

• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
  
  

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.