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Revenue Integrity Analyst III Job in Scarborough, Maine

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Job Title: Revenue Integrity Analyst III

Employer:Maine Medical Center
Type:Full-Time
Required Certifications:CPC) or Pharmacy Technician (CPhT),AHIMA (RHIA,CCS) or AAPC (COC,RHIT
Location:Scarborough, ME
Date Posted:7/10/2018

Revenue Integrity Analyst III

Maine Medical Center 

Scarborough, ME

Full Time, Days

 

Maine Medical Center is seeking a Revenue Integrity Analyst III in Scarborough. 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 is responsible for assisting Revenue Cycle Services, Coding, Clinical Documentation Improvement (CDI), and other departments with resolution of billing issues and/or denials requiring clinical expertise, participating in external audit requests, and special projects as needed. This position also serves as an audit outcome educator with clinical staff in clinic and department settings.

The Revenue Integrity Analyst III 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.

Qualifications:

  • ·        Technical or Bachelor’s degree preferred in healthcare, finance, health information or closely related healthcare field.
  • ·         Applicable professional certification through AHIMA (RHIA, RHIT, CCS) or AAPC (COC, CPC) or Pharmacy Technician (CPhT).
  • ·         Seven years’ experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: coding, contract management, denials/appeals, compliance, authorizations, care management, utilization review and auditing; Epic HB/PB experience preferred.
  • ·         Knowledge of revenue cycle processes and hospital/medical billing to include CDM, UB04, Remittance Advice (RAs), Federal Register(s), CMS Manual, Transmittals, commercial policies, and CMS 1500.
  • ·         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.
  • ·         Extensive working knowledge of healthcare compliance. Extensive understanding of medical terminology, anatomy and physiology along with clinic department activities.
  • ·         Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations along with facilitating to all member entities.
  • ·         Ability to work with and interpret detailed medical record documents and communicate effectively with physicians, nursing staff, leadership and other billing personnel.
  • ·         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.
  • ·         Ability to 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.

To apply, please click here or visit www.careersatmainehealth.org.  

About Maine Medical Center

Maine Medical Center is a complete healthcare resource for the people of greater Portland, the entire state of Maine and Northern New England. With a history dating back to 1864, Maine Medical Center is the state’s largest medical center and the flagship facility of MaineHealth, with 637 beds and more than 7,000 employees. In addition, we have achieved Magnet™ status in recognition of our commitment to the highest standards of nursing excellence. Maine Medical Center’s unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including the state’s only medical school, through a partnership with Tufts University School of Medicine, and a world-class biomedical research center, the Maine Medical Center Research Institute.

 

Inside and out, you’ll find what you’re looking for when you join Maine Medical Center. As the largest hospital in northern New England, MMC is committed to helping you grow professionally throughout your career. From tuition assistance and scholarships, to ongoing education, leadership training, mentoring and promotion opportunities, we offer the resources you need to achieve your career goals.

 

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

https://www.careersatmainehealth.org/job/8298807/revenue-integrity-analyst-iii-revenue-integrity/

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