Job Description​

The Revenue Integrity Analyst is responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Revenue Integrity Analyst works collaboratively with leadership to assist in development project management and
implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition this role monitors and analyzes coding performance at the section and business unit levels. The Revenue Integrity Analyst serves as the liaison between revenue cycle operations IT and finance as it
relates to charge capture documentation and reconciliation and possesses a clear understanding of the physician revenue cycle. The Analyst oversees understands and communicates departmental charging processes including the CDM charge linkages to the CDM and charging processes. The Analyst analyzes
and communicates denial trends to providers and operational leaders.

This position requires advanced knowledge in coding,  auditing, and documentation guidelines.  CPC  or CCS and CPMA or CEMA is required within 1 year of hire.   This position is a part of the Revenue Integrity Department and provides support to departments within the Revenue Cycle.  The primary role of this
position is to support education, documentation principals, clean claims, and denial prevention. Significant experience and/or certifications may substitute in lieu of degree.

Revenue Integrity Objective:  Supports Physicians, APPs and other billable providers by providing education on documentation and coding to the highest level of service being rendered. Serves throughout the revenue cycle, operations, and IT as it relates to charge capture, charge accuracy, documentation, denial prevention, and charge reconciliation while maximizing revenue and compliance.

• Analyze and conduct regularly scheduled chart audits and education for Physicians, APPs and other billable providers by evaluating education needs from audit results as outlined in our policies.
• Analyze and conduct audits for focused requests such as internal reviews, program & payment integrity reviews, payor programs.  Participate in facilitation of the process from time it is received to completion of request.
• Responsible for research and communication on regulatory requirements and payor policies that impact charging and reimbursement for the areas assigned.
• Identify education and improvement opportunities for accuracy, outliers and missed revenue by utilizing data such as:  revenue, RVUs, denials, CPTs by specialty, lag days in documentation to provide education to operational leaders and Physicians, APPs and other billable providers.
• Train departments on charge reconciliation.  Monitor to ensure the charge reconciliation is happening in the areas assigned.
• Monitor open encounters to ensure the chart is closing within the guidelines of the policies.
• Educate Physicians, APPs and other billable providers, practice leaders and revenue cycle on annual  coding updates and drive necessary EPIC revisions. Work with leadership to roll out new codes as applicable and timely.
• Analyze and ensure codes dropping are correct for all services rendered outside of that coded by HIM.
• Support operational leaders on efforts and initiatives related to charge capture, documentation, and reimbursement items.
• Collaborate with other departments (MILs, CDI, CDS, HIM, Charge Mgmt) and vendors to research where shared responsibilities for coding alignment or impact is needed.  

Job Requirements

Applicable Experience:

2 years

Cert Cardiovascular and Thoracic Surgery Coder (CCVTC) - American Academy of Professional Coders (AAPC)

None

Job Details

Full Time

Day (United States of America)

The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.