Revenue integrity professionals will create value for our clinical areas, principally in revenue recovery and claim acceleration.This role requires extensive knowledge of Medicare Integrated Outpatient Code Editor (I/OCE) associated with Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and quarterly Revenue Code additions, changes, and deletions.Accountable for assigned and delegated reports and completion from senior leadership and/or department director.Assist the Revenue Integrity Coordinator to ensure consistency in delivering services efficiently, timely, and great quality to all hospitals and BMH entities.Assist the Revenue Integrity Coordinator to ensure the integrity of the processes and that federal and state compliance is met in regards to charging and billing practices for healthcare services. Strives to reach and maintain department goals at the highest standard in all areas of responsibility, task, and patient satisfaction as set by Administration and Corporate expectation.Takes initiatives to improve processes, strives for positive customer outcomes.Leads by example.Responsible for all shifts, 7 days/week, 24 hours/day.Responsibilities
Requirements, Preferences and Experience Education
- The revenue integrity analyst will work throughout the organization with all types of departments to ensure the implementation of any newly implemented workflows and procedures to assure accurate charge processes are maintained, and achieving the organization's financial goals.
- Has joint ownership of assigned account and claim edit work queues, clinical departments and continually coordinates between administrative and clinical operations staff to ensure accounts have the correct coding, billing, payment and charge captures.
- Serves a resource and liaison for clinical charging and financial areas as related to appropriate coding and charge capture compliance based upon regulatory, coding, and billing guidelines by payer.
- Review patient medical records for charge capture and resolution of charge department billing edits in conjunction with reviewing clinical documentation to validate missing charges.
- Demonstrates Service First characteristics to all. Sets example for department and other hospital personnel. Identifies opportunities for improvement resulting in enhanced service and customer satisfaction.
- Performs related accountabilities/responsibilities as required or directed without complaint.
Preferred: Bachelor's degree in Health Information Management or Nursing.
Minimum: Associate Degree or equivalent experience of 5 years or more working in a hospital/physician office settingExperience
Preferred: A minimum of 6 years in the healthcare industry with a working knowledge of hospital and/or physician revenue cycle functions.
Minimum: A minimum of 3 years in the healthcare industry with a working knowledge of hospital and/or physician revenue cycle functions.Licensure, Registration, Certification
Preferred: LPN or RN
Minimum: Certified Coding Specialist-Hospital-Based (CCS-H), Certified Outpatient Coder (COC), Certified Professional Coder (CPC), RHIT, or RHIATraining
Minimum: Working knowledge of current medicare, medicaid, and other regulatory IPPS/OPPS guidelines and requirements; nThrive Knowledge Source application; Working knowledge of Microsoft Office products. Attention to Excel application; Knowledge of the different types of clinical settings; Knowledge of facility and professional billing claim forms, fields, and values; Knowledge of facility and professional billing requirements; Knowledge of medical coding rules and regulations.About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.At Baptist, We Offer:
- Competitive salaries
- Paid vacation/time off
- Continuing education opportunities
- Generous retirement plan
- Health insurance, including dental and vision
- Sick leave
- Service awards
- Free parking
- Short-term disability
- Life insurance
- Health care and dependent care spending accounts
- Education assistance/continuing education
- Employee referral program
Position: 10252 - Analyst-Revenue Integrity
Facility: BMHCC Corporate Office
Department: HS Revenue Process & Analysis Corporate
Category: Finance and Accounting
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Located in the Memphis metro area