Revenue Integrity Analyst, Remote

Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County.

Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.

SUMMARY:

We are currently seeking a Revenue Integrity Analyst to join our Revenue Integrityteam. This full-time role will primarily work remotely (days).

Purpose of this position: Maintains HHS charge master while preventing, identifying and monitoring for revenue leakage. Ensures compliance with state, local and federal regulations. Provides charging workflow support, education and feedback to clinical leaders and ancillary staff.

Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Nevada, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

RESPONSIBILITIES:

• Understand charge master set up and ensures maintenance requirements are met.
• Understand and communicate processes for accurate, compliant charge capture and documentation requirements for appropriate billing
• Maintain extensive knowledge of ICD-10-CM, CPT/HCPCs procedure coding and revenue codes along with UB-04 and 1500 billing requirements
• Monitors federal, state and local regulations and alerts appropriate stakeholders to changes
• Conducts annual cost center quality reviews leveraging reporting tools to evaluate for charge capture gaps as well as the appropriateness of services billed based on supporting documentation, procedural (CPT/HCPCS) codes selected and appropriateness of modifier usage to identify potential opportunities for revenue capture and recognize areas of compliance concern
• Develops and executes departmental review projects with measurable financial and/or compliance goals per analysis findings
• Rolls out regular updates of CPT/HCPCS and regulatory changes which includes identifying codes that have been deleted, added, or replaced and ensuring the appropriate system changes are made, supporting education presented, and proper communication is provided to all impacted stakeholders
• Work in collaboration with clinical areas, EHR, informatics, compliance, contracting, and other revenue cycle partners to ensure Revenue Integrity
• Monitor for and identify regulatory and/or reimbursement issues resolving them at root cause in an expedient and proactive manner
• Assists with onboarding and serves as an educational resource to revenue cycle, clinical leadership, MA's, RN's and other clinical staff regarding coding and billing trends and related quality metrics
• Trains, monitors and supports charge capture reconciliation processes in clinical areas
• Provide continuous quality control through work queue monitoring, variance checks, analysis, troubleshooting and detailed research
• Organizes, analyzes and presents data for the purpose of supporting clinical leadership, and other stakeholders throughout the organization to outline and institute strategies for improvement
• Other duties as assigned

QUALIFICATIONS:

Minimum Qualifications:

• Bachelors degree in Business Administration, Health Care Administration or related area

-PLUS-

• 2 years of experience in health care reimbursement, financial management or coding

-OR-

• An approved equivalent combination of education and experience

Preferred Qualifications:

• Minimum of three years' experience in directly related field
• Epic Certification in HB Resolute, CDM and/or and PB Resolute
• RN
• RHIA, RHIT
• CCS, CPC
• CRIP

Knowledge/ Skills/ Abilities:

• Knowledge of all third-party requirements, state and federal regulations
• Knowledge of government and commercial payer requirements for accurate and compliant healthcare charging and billing
• Extensive knowledge of CPT, HCPCs, and revenue codes
• Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting)
• Knowledge of regulatory publications, how to access and interpret
• Strong analytical and problem-solving skills
• Able to present to both small and large (up to 100) groups
• Initiate judgment, make decisions and work autonomously and remain adaptable
• Consistently demonstrate strong verbal and written communication skills at all times
• Ability to create strong collaborative relationships along with solid problem solving and conflict resolution skills
• Analytical and critical thinking skills

You've made the right choice in considering Hennepin Healthcare for your employment. We offer a wealth of opportunities for individuals who want to make an impact in our patients' lives. We are dedicated to providing Equal Employment Opportunities to both current and prospective employees. We are driven to connect talented individuals with life-changing career opportunities, enabling you to provide exceptional care without exception. Thank you for considering Hennepin Healthcare as a future employer.

Please Note: Offers of employment from Hennepin Healthcare are conditional and contingent upon successful clearance of all background checks and pre-employment requirements.