Senior Revenue Integrity Analyst

Department Strategic Planning

• Validate and approve access to all charge workflows and charge corrections, as directed by the CDM Supervisor.
• Provide education and in-service training to departments in collaboration with CDM Supervisor
• Provide assistance and analysis to all levels of clinical management in support of suggested, requested and/or mandated changes to the CDM.
• Process complex CDM requests to ensure that all additions, changes and deletions are consistent with proper charging, billing, coding and pricing practices in a timely manner.
• Conduct annual review of the charge master and quarterly updates as appropriate to enhance revenue for the hospital departments, including review of supplies, lab charges and pharmacy charges.
• Analyze data within the CDM and assign accurate CPT/HCPCS and revenue codes to the Charge Master to insure compliance with regulatory guidance, per Billing and Coding industry norms.
• Distribute coding and billing regulatory requirements and/or announcements to all applicable departments.
• Responsible to make CDM related decisions that require significant analysis and investigation.
• Assist with developing and maintaining policies and procedures for the CDM, Pricing Policies and charge capture processes.

Program and Service Administration and Implementation

• Perform all maintenance to the Charge Description and Service Master and the Room and Bed Master Files
• Create and maintain all hospital transaction codes and revenue department codes.
• Monitor and report all revenue department's charge volumes and posting lag days.
• Research and resolve all charge and service master related code errors that affect the recycle and reject reports.
• Assist in performing comprehensive reviews with clinical departments to ensure completeness and accuracy of charge description master.
• Take initiative to identify system and/or operational problems and participate in the development of solutions to improve billing functions.

Human Resources and Relationship Management

• Serve as expert resource for code and processing questions, train and educate coders.
• Maintain relationships with, and serve as liaison to department administration, physicians, clinic administration, information services, billing offices, financial offices and other departments.
• Participate in team meetings/activities and support the philosophy and goals of the team and department.
• Provide individual feedback and goal setting recommendations as directed by the Sr Manager
• Adhere to internal controls and reporting structure.
• Remain current with updated coding and billing regulations through yearly continuing education; read all announcements and relevant communications that relate to job duties.
• Lead special projects/assignments as directed by the CDM Supervisor.