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Revenue Integrity Analyst III Job in Scarborough, Maine

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Job Title: Revenue Integrity Analyst III

Employer:MaineHealth - Corporate
Type:FULL TIME
Job Location:Other
Required Experience:8 to 10 years
Location: Scarborough 04074, ME, US
Date Posted:7/27/2021

Revenue Integrity Analyst III

MaineHealth – Corporate

Scarborough, ME

Full Time - Days

 

*Remote work possible*

 

MaineHealth is seeking a Revenue Integrity Analyst in Scarborough. This position contributes and supports Revenue Integrity’s Mission towards creating a multidisciplinary revenue integrity team to strengthen the interface between clinical departments and charge improvement process. It is a holistic approach that guides the MaineHealth organization toward achieving operational efficiency, complete regulatory compliance, and total reimbursement.

 

Under the direction of the Director of Revenue Integrity, the Revenue Integrity Analyst III plays an important role in a high-profile group tasked with improving revenue results. This position is integral to the Revenue Integrity Team to assist in ensuring patient services are accurately charged, appropriately coded, supported by clinical documentation and that the related revenue is recorded in the proper department. In turn, this promotes revenue enhancement and compliance with laws and regulations with feedback and education to the hospital departments as needed.

 

This position maximizes efficiency through 1) monitoring and supporting revenue integrity processes, productivity measures and staff functions; 2) aiding in ensuring the accuracy and integrity of the revenue charge capture across the health system; 3) collaborating with team members to steer projects related to charge capture for financial success.

 

Qualifications:

  • Bachelor’s degree from a recognized college or university in business, healthcare or a closely related field or seven to ten (7-10) years of supervisory and/or leadership experience within the revenue cycle in lieu of education.
  •  COC, CPC, CCS certification required, or must obtain within 6 months of employment to the position.
  • Seven to ten (7-10) years’ experience in the hospital setting, healthcare industry with proven proficiency or past experience in a management position in the following areas: charge integrity; charge reconciliation; charge compliance; project and performance management, productivity measures with performance outcomes. Capacity to review, analyze and interpret data and analytics to root cause and implement corrective action. EPIC HB/PB experience preferred.
  • Extensive knowledge of revenue cycle processes and hospital/ medical billing to include CDM, UB, RAs and 1500. Extensive knowledge of code data sets to include CPT, HCPCS, and ICD 10. Extensive knowledge of NCCI edits, and Medicare LCD/NCDs. Extensive understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Strong understanding of billing guidelines and state and federal regulations with impact analysis. Ability to work with and interpret detailed medical record documents and communicate effectively with physicians, nursing staff, leadership and other billing or coding personnel.
  • Requires the ability to manage large complex projects assignments, investigate, analyze and resolve issues at a high level. Excellent communication, presentation, organizational, analytical and problem solving skills. Must approach problem solving challenges independently, have strong attention to detail and enjoy working in a fast paced, collaborative team based environment. Computer skills - MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet.

 

 

Working at MaineHealth:

With a career at any of the MaineHealth member organizations, you’ll be working with healthcare professionals who truly value the people around them – within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the wellbeing of our communities and employees. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Our care – and the science behind that care – are top rate. Join us and your abilities will be challenged and enhanced as you take your career to another level. 

 

As part of our dedication to operational excellence, we continually invest in technology, innovation and exceptional people in order to deliver on our promise to the people of northern New England. This includes the Shared Health Record initiative, which has changed the way we deliver healthcare within the state. We believe the electronic health record is a necessary tool in the improvement of healthcare delivery and outcomes. Our investment in the technology to support the electronic health record is nothing short of monumental. This means you’ll have the technology necessary to always ensure an optimal patient experience. 

 

When you join any of our organizations, you’ll find an environment that has the right combination of high-tech and high-touch to deliver the finest care to the people we serve. Join us to learn from – and be surrounded by – some of the best talent in healthcare today.

 

MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.

 

 

 

 

 

 

 

Applying

For more information or to apply, please click here or visit www.careersatmainehealth.org.

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