Revenue Integrity Certified Analyst Sr

At Moffitt Cancer Center, we strive to be the leader in understanding the complexity of cancer and applying these insights to contribute to the prevention and cure of cancer. Our diverse team of over 9,000 are dedicated to serving our patients and creating a workspace where every individual is recognized and appreciated. For this reason, Moffitt has been recognized on the 2023 Forbes list of America's Best Large Employers and America's Best Employers for Women, Computerworld magazine's list of 100 Best Places to Work in Information Technology, DiversityInc Top Hospitals & Health Systems and continually named one of the Tampa Bay Time's Top Workplace. Additionally, Moffitt is proud to have earned the prestigious Magnet® designation in recognition of its nursing excellence.
Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center based in Florida, and the leading cancer hospital in both Florida and the Southeast. We are a top 10 nationally ranked cancer center by Newsweek and have been nationally ranked by U.S. News & World Report since 1999.

Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. Join our committed team and help shape the future we envision.

Summary

Moffitt Cancer Center in Tampa, FL is recruiting for REVENUE INTEGRITY CERTIFIED ANALYST SR. For Florida residents and other select states (AL, AZ, AR, FL, GA, ID, IN, IA, KS, LA, MS, MO, MT, NC, OH, OK, SC, SD, TN, TX, UT, VA, WY) this full-time remote position offers a remote work arrangement.

Position Highlights:

The Revenue Integrity Certified Analyst Senior reviews and manages the operational functions of the quarterly charge audit process. This includes running reports, completing patient accounts audits and communicating the audit results to the clinical manager and the Revenue Integrity leadership.

The position reviews and completes assigned edits, simple and complex, in the billing system to ensure account resolution for timely claim submission following the Correct Code Initiative (CCI)/Outpatient Code Editor (OCE) according to the coding guidelines.

The Revenue Integrity Certified Analyst Senior serves as the backup support for Chargemaster maintenance. The position is expected to perform data analysis for optimization for process improvement as assigned by the Revenue Integrity leadership

ESSENTIAL FUNCTIONS:

• Reviews and manages the operational functions of the quarterly charge audit process. This includes running reports, completing patient accounts audits independently and communicating the audit results to the clinical manager and the Revenue Integrity leadership


• Reviews Correct Coding Initiatives (CCI)/Outpatient Code Editor (OCE) edits for trending analysis and charge capture opportunities.


• Reviews and completes coding for all accounts - simple and complex - edits.


• Analyzes correlation between coding edits and departmental monthly charge reports.


• Review and quantify impact of coding changes before and after implementation.


• Supports timely resolution of issues related to billing, denials and charge capture.


• Serves as the backup support for Chargemaster maintenance.


• The position is expected to perform independent data analysis for optimization and for process improvement.


• Other duties as assigned

Minimum Requirement:

Experience:

• Minimum of six (6) years' experience in revenue integrity processes. Related experience may include a
  
  combination of charge audit, charge master maintenance, account coding for payor reimbursement.

Education

• High School Diploma/GED

Licensure - Certification

• One of the following certifications:
  
  
  
  • CPC) Cert Professional Coder
  
  
  • (CCS) Certified Coding Specialist
  
  
  • (COC) Certified Outpatient Coder
  
  
  • (CPMA) Professional Certified Medical Auditor
  
  
  • (CCS-P) Certified Coding Spec-Physician
  
  
  • (RHIT) Reg Health Info Technician
  
  
  • (RHIA) Reg Health Info Administrator
  
  


• *Any relevant certification from a governing body not listed above may be reviewed and considered by the business to satisfy this requirement
  
  
  
  
  • Registered Nurse (RN) *In lieu of certification (active) RN will satisfy the certification requirement
  
  

Minimum Skills/Specialized Training Required
• Experience with Ambulatory Payment Classification (APC) reimbursement, Center for Medicare and Medicaid Services (CMS) rules and regulations, coding and billing compliance.
• Demonstrated ability to interpret, analyze, develop, direct and implement action to comply with proposed or final Medicare regulations.
• Proficiency with financial data with billing and reimbursement related experience
• Understands financial management and health care reporting, including the relationship between the Charge Description Master (CDM), charging and cost reporting.
• Demonstrates knowledge of the charge development process and the interrelationship of cost accounting, cost management, decision support and related functions.
• Possesses a working knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), and Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding schemes.
• Possesses a working knowledge of hospital and professional claims forms.
• Understands charging processes and compliance issues and has the ability to provide resolutions by performing internet research, utilizing third party payor regulations, referencing coding guidelines, and referencing local Fiscal Intermediary and Center of Medicare and Medicare guidelines.
• Demonstrated knowledge of revenue cycle business processes, including scheduling, registration, documentation, coding, charge entry, billing, collections and reimbursement.
• Direct operations experience in one or more revenue cycle business processes (relevant consulting experience may substitute for operations experience).
• Ability to maintain patient and compliance information in strict confidence.
• Ability to work with & maintain confidentiality of physician, patient, patient account & personnel data.
• Demonstrates knowledge and proficiency of standard PC word processing, spreadsheet, database and presentation applications (e.g., Word, Excel, Access, PowerPoint) to develop, prepare and analyze statistical reports.
• Excellent project management, problem solving and analytical skills.
• Ability to work independently, identify and resolve problems.
• Excellent interpersonal and communication skills including ability to resolve conflicts with tact and diplomacy, work with all levels of management.

Preferred Experience
• Experience working with Cerner and Soarian applications

Equal Employment Opportunity

Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status. We seek candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence.

Reasonable Accommodation

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