SPHS Finance Administration
The Revenue Integrity Analyst will:
- Own the accuracy and integrity of the Epic charge description master, including charge codes, descriptions, CPT/HCPCS assignment, revenue codes, modifiers, units of service, and effective dating.
- Maintain fee schedule groups and pricing records and ensure price changes are applied to the correct entities.
- Maintain charge routing rules, charge triggers, and order-entry linkage.
- Identify and pursue missing charges through late charge analysis, revenue and usage variance review, and department reconciliation exception reporting.
- Analyze reimbursement variances where the root cause is charge or CDM related.
- Monitor high-risk charging areas on a defined cadence for high-dollar areas.
- Develop and deliver role-based charge capture and reconciliation training for all end users.
- Serve as a first-line consultant to clinical departments on how a new service, order, supply, or drug should be built, charged, and reconciled.
- Perform routine charge audits validating that services provided are documented, charged, coded, billed, and reimbursed correctly and consistently.
- Lead the annual pricing update process in partnership with Finance and Managed Care, including modeling of price change impact by payer, service line, and volume.
- Serve as the operational lead to the Financial Integrity Committee and maintain a centralized log of CDM requests.
Requirements & Qualifications
- Bachelor's degree in health information management, healthcare administration, finance, business, nursing, or a related field; equivalent directly relevant experience may be substituted.
- Minimum five years of hospital revenue cycle experience with direct chargemaster, revenue integrity, or hospital billing responsibility.
- Working knowledge of CPT, HCPCS, revenue codes, modifiers, UB-04 claim structure, NCCI and MUE edits, and OPPS/APC methodology.
- Ability to analyze charge, revenue, and reimbursement data and communicate findings to clinical and financial audiences.
- Experience training or advising non-financial clinical staff on charge capture.
- Strong Excel skills and ability to work with large charge and claim data extracts.
Benefits & Perks
Competitive base salary
- Medical, dental, and vision insurance
- Savings accounts
- Voluntary benefits
- Wellness programs and discounts
- Paid life insurance
- Generous 401(k) match
- Adoption assistance
- Back-up daycare
- Free onsite parking
- Recognition rewards
- Fully paid tuition program or tuition assistance program
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$90,771 - $149,739
Remote work allowed
No
Posted
2 weeks ago