SEARHC

Senior Revenue Integrity Analyst

WA - Renton Full time

Pay Range:

Pay Range:$36.46 - $51.29

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.

Responsible for improving the quality of the revenue cycle through the development of user education, coding/HIM workflow and process optimization, and EHR contributions as a coding/HIM subject matter expert.

Key Essential Functions and Accountabilities of the Job

  • Analyzes available data to support the Revenue Cycle Integrity team initiatives in defining and identification of end-user deviations and other inconsistencies

  • Acts as subject matter expert for CPT/HCPCS coding and documentation requirements

  • Obtains and compares data from multiple sources and reviews for discrepancies using various applications

  • Performs quality assurance and validation tasks

  • Provides education to patient revenue generating departments/providers to ensure compliant charging and coding practices

  • Develops training and informational documents for clinical and administrative staff in coordination with Informatics teams

  • Provides 1:1 provider education as requested

  • Assists in the design and maintenance of Coding modules and workflows

Core Responsibilities

  • Collaborate with HIM Management in EHR coding and coding support workflows

  • Provide SEARHC Providers guidelines ensuring compliant clinic documentation

  • Provider reviews in documentation and charge requirements to ensure reimbursement for services

  • Create and updating provider job aids supporting clinical services

  • Collaborate with the CI EHR Training Team on-boarding new providers

Other Functions

  • Coding/denials encounter reviews

  • Maintain existing job aids and workflows for HIM coding & coding support processes

  • Resolve/assign coding/coding support helpdesk ticket

  • Other duties as assigned

Education, Certifications, and Licenses Required

  • Bachelor's degree or an equivalent combination of education and/or work in Revenue Cycle/HIM/Coding – required

  • AAHAM Certified Revenue Cycle Specialist (CRCS) – preferred

  • AAHAM Certified Revenue Integrity Specialist (CRIP) – preferred

Experience Required

  • Five years minimum in hospital or physician billing office

  • Experience in completing hospital charging practices and the revenue cycle flow in hospital financial systems

Knowledge of

  • Revenue Cycle, Clinical Documentation, support applications, and user workflows implicated in Coding and HIM functions

  • Interface methods, dataflow within the Relational Database Model

  • Billing and coding practices for IHS, CAH, FQHC, Provider and ancillary services

  • CPT, HCPCS, revenue code, ICD-10CM

  • Payer and NCCI edits, rejections, rules, and how to appropriately respond to each

  • Specific system and payer requirements required for billing

Skills in

  • Critical thinking (problem solving, troubleshooting)

  • Developing new methods to define and identify statistical outliers

Ability to

  • Work on different projects simultaneously, work in fast paced setting and multitask in a fast-paced environment and appropriate handle overlapping commitments and deadlines

Computer Skills

  • Highly proficient in relevant computer applications including Microsoft Office programs, including Word, Excel

  • Manipulating large datasets (500,000+)

  • Cerner and other electronic records applications

Required Certifications:

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!