Revenue Integrity Analyst / Claims Review Specialist Location: 10920 Wilshire Blvd, Los Angeles, CA 90024
Duration: 24 week contract
SHIFT: M-F 8-5
Note: This will be 99% remote, only the orientation will be onsite and a few meetings when necessary.
REQUIRED EXP: 5+ yrs exp with hospital billing systems and third-party billing requirements, Bachelor's Degree, coding certification (CPC,CPCH, AHIMA etc) Knowledge of ICD10CM CPT, Medicare, Medi-Cal and Commercial Payers processing, Denials management Preferred Take on a significant role within a world-class health organization. Elevate the operational and financial effectiveness of a complex health system. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will: Analyze complex financial data Identify trends in revenue cycle operations Summarize data and present reports to leadership Serve as liaison with departments to thoroughly define reporting and information requirements Evaluate revenue cycle workflows to identify areas for improvement Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems Train patient financial services units on revenue cycle systems, processes and procedures Maintain compliance with government regulations, reimbursement issues, etc. Analyze hospital billing claims within the EHR and claim scrubber system Resolve claim errors, edits, and other holds Works with clinical and ancillary operational departments on correct coding, billing, and charging principles
We're seeking a highly analytical, detail-driven professional with: Bachelor's degree in business, finance or related field CPC-H, CPC, or CCS coding certification Five or more years of experience with hospital billing systems and third-party billing requirements Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations Proficiency with Microsoft Excel Knowledge of Tableau Reporting dashboards Understanding of Medicare/Medi-Cal claims processing guidelines Experience with EPIC EHR, Cirius Claim Scrubber, or other EHR system In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle Strong analytical and problem-solving abilities Excellent communication, interpersonal, and collaboration skills Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes
