Revenue Integrity Analyst

Shriners Children’s is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience defines us as leaders in pediatric specialty care for our children and their families.

Job Overview

Shriners Children’s is the premier pediatric burn, orthopaedic, spinal cord injury, cleft lip and palate, and pediatric subspecialties medical center.  We have an opportunity for a remote Revenue Integrity Analyst for our Headquarters location. Do you have demonstrable revenue cycle and hospital-based billing or coding experience, and would you like to use your skills to further Shriners Children’s mission of providing the best quality care to our pediatric patients and their families?  Then this position may be for you!

The Revenue Integrity Analyst is responsible for evaluation, assessment and education to Shriners Children’s (SHC) hospitals as a component of conducting audit processes and ensuring adherence to SHC revenue cycle policy. Also responsible for the development and adherence to processes and procedures to assure timely and appropriate capture of all chargeable activities throughout SHC. The development of a means to facilitate collaboration and standardization across all venues of care within SHC in support of charge capture. Assures accurate and timely auditing of revenue cycle chargeable services and activities throughout SHC. Utilizes skills to professionally communicate and facilitate the collaboration and standardization of charge capture processes, across all venues, within SHC in support of revenue integrity.

Responsibilities

Responsibilities include conducting revenue integrity audit activities for compliance related to internal policy, CMS, Medicaid and managed care regulations and requirements, communication, outcomes analysis and reporting for the purpose of internal quality control; providing analysis, trended reports and well supported documentation for audit findings, recommendations and/or corrections to individual hospital processes according to best practice, compliance and SHC policy; and assisting in identifying, defining and functioning within software (i.e. Craneware and MedeAnalytics) processes; review and/or development of reports and audit tools to support the requirements for revenue integrity and outcomes measurement.

Qualifications

7 years of hospital-based revenue cycle experience, focused on revenue integrity and compliance, is required  3 years of hospital-based billing or coding experience focused on charge capture required.  Charge capture, billing or coding experience in one or more of the following is required: pharmacy, radiology, surgery/anesthesia, outpatient clinic, inpatient hospital.  Would prefer charge capture, revenue integrity and/or patient access experience in one or more of the following: hospital-based clinic, inpatient hospital. Clinical experience blended with revenue cycle is a plus. Bachelor’s Degree in business/accounting/finance or healthcare/business administration – combination of current education pursuit and experience considered. Certification in CCA, CCS, CHC, CDIP, CMAS, or RHIT a plus.

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