Primary City/State:

Arizona, Arizona

Department Name:

Revenue Integrity-Corp

Work Shift:

Day

Job Category:

Revenue Cycle

In 2021, Banner Health was awarded the designation of “Top Revenue Cycle Performance for Large Systems” during the Revenue Cycle Excellence Awards held by Crowe, a national public accounting, consulting and finance service company. The Banner Health Revenue Cycle team was selected for this distinguished designation out of 1,400 large hospitals across the country. Join a team recognized for the innovative and effective strategies that have enabled us to achieve excellence in revenue cycle performance.

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

As an Acute Intermediate Revenue Integrity Analyst you will work with a variety of claims, correcting coding or charging errors that may prevent a bill from going to the payer. You will have an opportunity to work for a team that provides, flexibility and many growth opportunities.

Desired background: Revenue integrity/ Charge OR Coding

Acute Hospital experience needed

This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV

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, under the direction of the Revenue Integrity Director, 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. This position 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. Acts as liaison between physician practices and coding to provide oversight and communicate provider charge capture performance. Closely aligns with physician coding to support the physician practice in achieving a healthy revenue stream. Partners with Coding, Cerner Clinical Informatics and Revenue Cycle teams to ensure an uninterrupted revenue cycle and support performance improvement opportunities.

2. Partners with physician practice leaders to provide oversight on open encounters and unsigned orders for a positive impact on timeliness of charges and ultimately the revenue cycle. Ensures new lines of service are communicated and set up proactively. Coordinates department requested CDM charge additions and deletions as applicable.

3. Identifies areas of risks and opportunities to improve compliance and revenue management. Monitors and resolves audit work queues, proactively identifies revenue opportunity and suggests improvements. Maintains knowledge of current coding and documentation requirements as required for compliant billing.

4. Collaborates with Clinical Informatics to provide feedback, training and education to providers regarding standardized charge capture workflows. Develops automated processes to replace manual workflow when able.

5. Provides guidance and education to departments as a subject matter expert on compliant charge capture and charge reconciliation. Provides revenue integrity training to new practice leaders and on an ongoing basis to ensure charge reconciliation procedures are being followed, assisting the practice leader with issue management and resolution.

6. Collaborates with Revenue Integrity Director to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics. Analyzes and quantifies analytics dashboard results. Prepares timely and accurate reports for presentation to departments, senior leadership, Revenue Integrity and Continuous Improvement forums to support prevention of lost revenue. Escalates variances and collaborates with stakeholders for resolution and process improvement as indicated.

7. Reviews charging performance against standards and trends. Works with stakeholders to identify root cause and implement solution to remediate charge capture issues. Works with a variety of departments including senior leadership, physician practice, finance, coding, and revenue cycle to assist with data gathering and/or interpretation. Ensures the integrity of reports and databases used for Revenue Integrity.

8. Provides support for special projects assigned to the department by management for analysis. Brings strength in logic and analysis of data, sorts through data and determines which elements are pertinent to the project. Identifies and recognizes trends, presents data and analysis results to appropriate parties.

9. Works independently under general supervision and direction of the Revenue Integrity Director. Collaborates with Physician Department Leadership, Administration, Data Operations, Finance, Patient Access Services, Coding, and Patient Financial Services. Provides management with accurate and timely information necessary to effectively manage financial operations. Uses specialized knowledge and independent judgement to analyze information and solve problems. Researches complex charging/billing issues and provides education and recommends process improvements to ensure compliant charge capture and reimbursement. Work output has a significant impact on physician group revenue and department goals. Customers include physicians, nurses, coders, third party payors, central billing staff, and patients/patient families.

MINIMUM QUALIFICATIONS

Requires a Bachelor’s degree in Business, Finance, Health Management or related field or equivalent experience.

Requires a proficiency level typically attained with 3-5 years of experience in healthcare related work in a clinical, medical office or acute care setting. Must be knowledgeable of medical terminology and current regulatory agency requirements for coding and have a good understanding of reimbursement methodologies. Must have excellent analytical and organizational skills and the ability to manage multiple priorities with changing needs and deadlines. Requires excellent human relations skills and the ability to effectively interact and communicate both verbally and in writing with all levels staff and outside professionals.

Requires strong abilities in analysis, data interpretation, computer software applications, database and spreadsheet programs, plus a proficiency in generating management reports, projections, allocations, and analyses.

PREFERRED QUALIFICATIONS

Preferred licensure includes coding credentials (e.g. CCA, CCEP, CCS, CCS-P, COC, CHC, CHFP, CPC, CRCM, RHIT, etc.).

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability