Revenue Integrity Analyst I

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 [client name] organization toward achieving operational efficiency, complete regulatory compliance, and total reimbursement. 

Under the direction of the Director of Revenue Integrity, this position is responsible for monitoring, identifying, correcting, with analysis of account errors prior to claim submission to include Discharge Not Billed (DNB), Stop Bills(SB), Workqueues (WQ) and Dashboards.

Daily Functions:

• Assist in daily resolution of billing edits that are holding patient claims from billing, by reviewing the medical records and other applicable documentation.
• Expected to identify report and participate in the resolution of any potential or actual revenue/charge related issues.
• Coordinate Charge Description Master (CDM) error findings with CDM team.
• Reviews patient records and is able to assist with account fixes, charge reconciliation for other departments based on clinical documentation.
• Monitor EPIC Revenue Integrity Dashboard(s).
• Responds to departmental charging inquiries timely.
• Provide support for assigned cost centers within service lines and in collaboration with your team.
• Works with Coding and other clinical departments to identify/fix errors based on ICD/CPT 
• Coding Guidelines and National Correct Coding Initiative edits.
• Contributes in support of quarterly improvement initiatives through reviews as directed by department director or team leader.
• Serve as primary service line representative for all charge related inquiries and issues and proper usage of charge codes.

General Expectations:

• Perform quality work within deadlines and/or Key Performance Indicators (KPIs) with or without direct supervision. 
• Interacts professionally with coworkers and customers.
• Work effectively as a team contributor on all assignments.
• Works independently while understand the necessity for communicating and coordinating work efforts with other employees and organizations.
• Delivers positive patient experience, where applicable.
• Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.

Education: 

• High school diploma or GED. 

License/Certifications:

• Applicable professional certification through AHIMA (CCA) or AAPC (CPC A, COC-A) are highly desirable. Must obtain professional credential within 6 months of employment. 

Experience: 

• One (1) to three (3) years of experience in the hospital setting, healthcare industry or coding. EPIC HB/PB experience preferred. 

Proficiencies: 

• Current knowledge of revenue cycle processes and hospital/ medical billing. Understanding of components of electronic medical record. Current knowledge of code data sets to include CPT, HCPCS, and ICD. Current knowledge of NCCI edits, and Medicare LCD/NCDs. 

Abilities: 

• Due to its service focus, this position requires interpersonal and communication skills, analytic and organizational skills, critical thinking and the ability to meet deadlines. Computer skills; MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet.

$51,355.20 - $74,851.92/year

• Remote role (based out of Greenville, NC)
• Monday - Friday day shift
• Great Benefits

#LI-REMOTE

#LI-AH2

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children¿s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant¿s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.