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Geisinger

Revenue Integrity Reconciliation Analyst I (Pennsylvania resident)

Posted 3 days ago
2-5 years experience
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AI Summary

The analyst is responsible for reconciling physician and hospital-based service charges to ensure accurate revenue capture and compliance with department policies. They monitor reconciliation dashboards, identify billing trends or omissions, and collaborate with clinical operations to resolve discrepancies.

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

No

Job Summary:

Completes charge reconciliation based on predetermined policies to ensure all charges are processed timely and accurately, while maintaining high standards set forth by the Revenue Management department. Assists with analyzing and reconciling physician and hospital-based services provided in clinical or outreach facilities. Works in conjunction with Clinical Operations staff to ensure timely capturing of revenue, assisting to identify trends and/or omissions and contributes to the weekly updates provided to each Institute.

Job Duties:

  • Gathers, monitors, reviews, and analyzes reconciliation data reports for assigned Institute Revenue Hub Dashboards.
  • Responsible for identifying and reporting to Manager/team members any trends or issues identified through daily review and analysis.
  • Assistance with gathering reconciliation data for other team members as required, providing a detailed summary of findings.
  • Maintains communication with management and senior team member.
  • Works with appropriate personnel when assistance is needed to complete issue resolution and escalates ongoing problem issues to the Manager
  • Comparison of Electronic Medical Record (EMR) to professional and hospital billing to ensure accurate coding and billing practices.
  • Reports shortfalls and trending issues related to information that prohibits accurate charge or data capture.
  • Supports efforts to audit Revenue Capture policies and procedures to ensure compliance of published Revenue Capture protocols.
  • Works in conjunction with other areas within Revenue Management and Geisinger departments to ensure coordinated activities, with respect to all Revenue Management needs.
  • Assists and provides coverage for other team members in the completion of their assigned duties to ensure timely and accurate revenue recognition.
  • Based on established criteria, ensures all billable services are accurately captured in appropriate billing system.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

*Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

Position Details:

Internet requirements:

Employee required to have/supply: Cable modem, (high speed, only - No DSL or Wireless Cellular Service or Satellite Service) The minimum requirement is:

  • •25 MBPS UP
  • •75 MBPS DOWN
  • •<150 ms Ping Required
  • •<30ms Jitter Required

Computer must be connected to the internet via Ethernet cable; wifi is not permitted unless a Virtual Private Network (VPN) is used for the wifi connection

Education:

High School Diploma or Equivalent (GED)- (Required)

Experience:

Minimum of 2 years-Relevant experience* (Required)

Certification(s) and License(s):

Skills:

Communication, Computer Literacy, Teamwork

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

  • KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
  • EXCELLENCE: We treasure colleagues who humbly strive for excellence.
  • LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
  • INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
  • SAFETY: We provide a safe environment for our patients and members and the Geisinger family. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all.  We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

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