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Revenue Integrity has become a leading national focus to gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue Integrity in an integral part of the Revenue Cycle and covers all essentials related to it. We have teams comprised of Charge Capture, Pre-bill, Post-bill and Monitoring (Auditing). RI also utilizes technology to enhance achievement along with an added focus where necessary that may include high dollar accounts, denials, improved A/R days and cash flow while collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement
The Revenue Integrity Analyst I will work with a variety of claims, correcting coding or charging errors that may prevent a bill from going to the payer.
Your pay and benefits are important components of your journey at Banner Health. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
POSITION SUMMARY This position is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection. This position is responsible to discover revenue issue root cause and to develop correction action plan and provide charge capture education. In addition, recommend modifications to established practices and procedures or system functionality as needed to support revenue cycle and manage implementation of the recommended changes. The Revenue Integrity Analyst will work with internal customers to ensure newly implemented workflows and procedures, support revenue cycle integrity and to achieve revenue cycle's financial goals.
CORE FUNCTIONS 1. Reviews facility daily gross revenue reports for variances. Collaborates with department directors/managers to review variances. Escalates variances related to charge capture and collaborates with Revenue Cycle team for process improvements as indicated.
2. Provides concurrent and retrospective charge reviews across Banner facilities comparing clinical documentation to billed charges as directed by Revenue Integrity Manager, Compliance and facility requests. Identify charge capture opportunities, proactively identifying revenue opportunity and suggests improvements.
3. Monitor/Resolve nThrive charge capture work queues to identify opportunities for improvement in charge capture, clinical documentation and system enhancements to improve charge capture. Maintains a current knowledge of coding and documentation requirements as required for compliant billing.
4. Collaborates with Revenue Integrity Senior Manager to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics.
5. Analyzes and quantifies all charge capture review results for reporting to departments, CFO and Revenue Integrity Continuous Improvement Forums.
6. Provides guidance and education to departments as a subject matter expert on compliant charge capture and charge reconciliation.
7. Provides education to departments on how to work charge rejection log to ensure all charge are captured to avoid missed revenue and reduce late charges.
8. Coordinate department requested CDM charge additions and deletions as applicable. Partners with Coding, Cerner Clinical Informatics and Revenue Cycle teams to support performance improvement opportunities.
9. Works independently and in collaboration with Revenue Cycle Team under the direction of the Revenue Integrity Senior Manager. Researches complex charging/billing issues and provides education and recommends process improvements to ensure compliant charge capture and reimbursement. Uses structured work procedures and independent judgment to solve problems and achieve high quality levels. Work output has a significant impact on system business goal attainment. Customers include facility ancillary departments, physicians, nurses, third party payors, central billing staff, and patients/patient families.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.
Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an Associate's degree Applied Health Sciences, Finance or health related field.
Requires a level of knowledge normally gained over 2-3 years of related work in the same type of clinical, medical office or acute care unit. Must be knowledgeable of medical terminology and current regulatory agency requirements for coding and charging for the assigned clinical area and have a good understanding of reimbursement methodologies. Requires strong abilities in researching, reading, interpreting and communicating financial data as related to charge capture, effective interpersonal skills, organizational skills and collaborative team working skills.
Must be able to work effectively with Microsoft office software, coding and billing software, Cerner, NextGen and MS4.
Additional related education and/or experience preferred.
DATE APPROVED 05/19/2019
Internal Number: R4219
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.