Revenue Integrity Analyst

at R1 RCM in Chicago, Illinois, United States

Job Description

R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly-traded organization with employees throughout the US and international locations.

Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.

As our Revenue Integrity Analyst, you will ensure accurate and optimal revenue capture for services provided and managing and maintaining the hospital’s Charge Description Master (CDM). Everday you will ensure that all services and procedures are accurately listed in the CDM to reflect the hospital’s current offerings. To thrive in this role you must have a coding certification and experience working in revenue cycle.

Key Responsibilities:

CDM Maintenance:

+ Developing and implementing pricing strategies for various services and procedures, considering factors like costs, market rates, and reimbursement policies.

+ Ensuring that hospital policies and procedures related to billing and coding are followed by all relevant departments.

+ Analyzing billing trends and identifying opportunities for revenue improvement or areas of potential compliance risk.

Charge Capture Analysis:

+ Review and analyze patient records, billing data, and financial statements to ensure accurate charge capture.

+ Identify discrepancies or errors in charge capture processes and rectify them.

Coding Compliance:

+ Verify that medical codes (ICD-10, CPT, HCPCS) assigned to procedures and diagnoses are accurate and compliant with coding guidelines.

Reimbursement Review:

+ Analyze payer contracts and reimbursement rates to ensure that services are billed and reimbursed appropriately.

Qualifications:

+ Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or similar coding certification required

+ 3 years’ experience in Hospital Based Charge Description Master or Revenue Integrity

+ In-depth knowledge of healthcare reimbursement methodologies, coding systems, and billing regulations.

+ Intermediate Excel experience: must be able to perform Vlook-up function

+ Preferred experience with Epic

For this US-based position, the base pay range is $41,677.00 – $58,093.00 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is always evolving – and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team – including offering a competitive benefits package. (http://go.r1rcm.com/benefits)

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf)

To learn more, visit: R1RCM.com

Visit us on Facebook (https://www.facebook.com/R1RCM)

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.

Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”