Revenue Integrity Analyst

Lake Charles Memorial Health System


Date: 2 weeks ago
City: Lake Charles, LA
Contract type: Full time
Revenue Integrity Analyst

Description Of Position

  • The primary function is to assist the facility in maximizing patient revenue through monitoring of the scheduling, billing, and charging activities. Includes resolving issues related to the facility financial systems that directly affect revenue generation. Also serves as the System Analyst and CDM Coordinator for the Moss Memorial Campus.

SUPERVISION: Reports directly to the Director of Revenue Management

Responsibilities And Duties

  • Maintains the Health System CDM and makes changes to templates as requested by authorized person.
  • Performs chart and charge audits as requested by supervisor or as needed by the identification of billing or documentation issues.
  • Educates staff on scheduling, charging, and documentation.
  • Balances team and individual responsibilities.
  • Exhibits confidence in self and others. Inspires and motivates others by persuasion rather than intimidation. Walks the talk.
  • Demonstrates persistence and follow through even when faced with adversity or challenges.
  • Serves as system liaison with the HBO and CBO - reporting any system issues as needed including working to help resolve the issues.
  • Manages daily work queues to resolve bill holds for charge-related issues assigned to the revenue integrity unit in the charge and discharge not billed (DNB) work queues. Conducts daily review of claims held in charge and discharged not final billed (DNFB) applications. Distributes these charge related issues to the proper department. Maintains the charge integrity contact list for distribution of charge-related issues to PFS, HIM, coding, clinic services, surgical services, and ancillary services.
  • Assists with report findings from the assigned work queues, erroneous or missing charge postings with follow-up analysis, and development and implementation of recommendations and actions plans to minimize late or missing charges.
  • Reviews and assists with maintenance of chargemaster compliance reports. Assists with other necessary projects to maintain the chargemaster file.
  • Develops charge capture for the Hospital System, including providing the necessary information from the Charge Description Master.
  • Monitors and ensures compliance with Privacy and HIPAA related activities as it relates to system access.
  • Assists departments with financial system related issues and questions including, but not limited to interfaces, pathways, order entry, etc.
  • Responsible for acquiring data for the Health System needed for gathering comprehensive system statistics.
  • Works with the Business Office on billing edits, denials, and medical necessity.
  • Assists with RAC requests which includes detail analysis of patient accounts.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Education And Work Experience

  • Bachelor's Degree in Business Administration, or Healthcare related field preferred. Consideration may be given for the right combination of experience and education.
  • Five years of System Analyst or Healthcare Revenue Cycle experience.
  • Working knowledge of computer operations and electronic interfaces.
  • Strong organization skills working effectively in a multi-task environment, prioritizing tasks properly and completing tasks/projects in a timely manager.
  • Demonstrated proficiency in written and verbal communication skills.
  • Ability to work in a fast paced environment and remain calm and flexible under stressful situations. Ability to build and work in a collaborative team work environment.

Physical Demands/Work Environment

  • Occasional standing, walking, frequent sitting for long periods of time, manual dexterity.
  • Work is normally performed in a typical interior/office work environment.
  • Light physical effort; repetitive motion of wrists, hands and/or fingers; standing, walking, lifting, reaching, kneeling, bending, stooping, pushing and pulling; frequent sitting.
  • Ability to read forms, computer screens, correspondence and other documents.
  • Work may include work on evenings, nights, weekends and/or holidays to ensure effective productivity.
  • Ability to deal with stressful situations and conflict resolution.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

“Experience Memorial” is more than a slogan, it’s the care we provide our patients and it’s the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.

Working at Lake Charles Memorial Health System | Great Place To Work

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