Revenue Integrity Analyst Senior
Mclaren Healthcare
Assists Manager Corporate Revenue Integrity in developing and implementing common systems and processes related to revenue integrity across all McLaren subsidiaries. Conducts complex audit projects and revenue analysis to ensure revenue integrity. Develops processes which are designed to optimize and support revenue integrity, reduce risk and eliminate waste. Ensures documented charges are correctly billed and billed charges are documented in the medical record.
Essential Functions and Responsibilities:Assists Manager Corporate Revenue Integrity in planning and management of MHC revenue cycle integrity functions for McLaren subsidiaries.
Plays key role in development of policies, procedures designed to enhance, support and optimize revenue cycle integrity.
Applies a working knowledge of compliance with federal, state, local and third-party payer rules and regulations to complex audit projects, ensuring that the coding reflects what is documented in the medical record.
Serves as a clinical and coding knowledge expert; assists with updates and reviews appropriate charge master CPT, HCPCS and revenue codes with a focus on standardizing like items; working toward eventual implementation of a corporate charge master across McLaren subsidiaries.
In collaboration with Manager Corporate Revenue Integrity, develops processes and tools to analyze financial and clinical indicators to identify and remedy unexpected variances.
Works with hospital department leadership to implement internal controls when errors are identified.
Develops, analyzes and disseminates revenue cycle analyses (including third-party billing and charge description master) which will assist the management team, including senior management, in assessing and evaluating the strategic initiatives for the hospital.
Required:Bachelor’s degree required in nursing or related clinical field.Five years’ experience working with hospital clinical and financial data and expertise working with through these complex relationships to produce solutions that ensure revenue integrity.Two years proven experience in a revenue cycle process role with increasing responsibility.Preferred:Coding certification Equal Opportunity Employer of Minorities/Females/Disabled/Veterans Additional Information Schedule: Full-time Requisition ID: 24008123 Daily Work Times: Standard Business Hours Hours Per Pay Period: 80 On Call: No Weekends: No
Essential Functions and Responsibilities:Assists Manager Corporate Revenue Integrity in planning and management of MHC revenue cycle integrity functions for McLaren subsidiaries.
Plays key role in development of policies, procedures designed to enhance, support and optimize revenue cycle integrity.
Applies a working knowledge of compliance with federal, state, local and third-party payer rules and regulations to complex audit projects, ensuring that the coding reflects what is documented in the medical record.
Serves as a clinical and coding knowledge expert; assists with updates and reviews appropriate charge master CPT, HCPCS and revenue codes with a focus on standardizing like items; working toward eventual implementation of a corporate charge master across McLaren subsidiaries.
In collaboration with Manager Corporate Revenue Integrity, develops processes and tools to analyze financial and clinical indicators to identify and remedy unexpected variances.
Works with hospital department leadership to implement internal controls when errors are identified.
Develops, analyzes and disseminates revenue cycle analyses (including third-party billing and charge description master) which will assist the management team, including senior management, in assessing and evaluating the strategic initiatives for the hospital.
Required:Bachelor’s degree required in nursing or related clinical field.Five years’ experience working with hospital clinical and financial data and expertise working with through these complex relationships to produce solutions that ensure revenue integrity.Two years proven experience in a revenue cycle process role with increasing responsibility.Preferred:Coding certification Equal Opportunity Employer of Minorities/Females/Disabled/Veterans Additional Information Schedule: Full-time Requisition ID: 24008123 Daily Work Times: Standard Business Hours Hours Per Pay Period: 80 On Call: No Weekends: No
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