nThrive

Charge and Revenue Integrity Analyst

Job ID
2020-28383
Employment Type
Full Time
Hours Per Week
40
State
Remote

Overview

The Charge & Revenue Integrity Analyst develops and maintains the Charge Capture Audit (CCA) rules database, provides general rules analysis to identify charge capture issues for hospitals, as needed.  The analyst must be able to analyze and present data, communicate clearly and concisely, and work independently. 

Responsibilities

  • Develop new rules based on changes in regulatory guidelines, new products and services, revenue, volume, and other considerations.
  • Maintain rules database based on research and regulatory changes.
  • Develop rule reports based on client requests and in line with company proprietary guidelines.
  • Define rule explanations clearly and consistently with references as available.
  • Organize/categorize rules by type within the rules database.
  • Analyze Standard/CPM codes and recommend changes and /or updates related to mapping.
  • Review false-positive results weekly to identify areas within the rules database that may need further maintenance and/or update.
  • Respond to customer queries regarding CCA rules via Salesforce within 48 hours with explanation, modification, or update on when follow up information will be available.
  • Assist in conducting daily rule deployment of rule updates.
  • Participate in internal conference calls that support the rule development and customization process.
  • Develop & distribute monthly CCA rule forecast & release notifications.
  • Review and analyze regulatory guideline and code changes, for impact to rules database.
  • Review and analyze client databases to recommend and develop custom rules.
  • Utilize appropriate logs and tracking systems for rules additions, modifications, inactivation’s, and custom rules.
  • Assist in providing internal training related to rules development when needed.
  • Perform QC audits for new & modified general rules.
  • Perform QC audits for new & modified custom rules for clients as needed.
  • Daemonstrated bility to work independently.
  • Expand and maintain professional skillset for continue growth.
  • Utilize resources for researching and validating rule issues.

Qualifications

  • High School Diploma or GED.
  • 2+ years of experience in coding or auditing hospital Medical Records and applying technical ICD-10, CPT, and HCPCS coding. 
  • Nationally recognized coding credential required (CPC, COC/CPC-H, CCS, CCS-P, RHIT, RHIA).
  • Ability to read, research, analyze, interpret general business periodicals, professional journals, technical procedures or governmental regulations.
  • Must be proficient in MS Office, particularly Excel and Access, and be very detail oriented. 
  • Ability to work in a team environment that requires quick turnaround and quality output.
  • Ability to adapt to change as needed.
  • Ability to write and communicate effectively.

Preferred Skills

 

  • Associates or Bachelors degree is in related field such as Health Information Management.
  • Comprehensive understanding of hospital chargemaster.

About nThrive

Be Inspired. Ignite Change. Transform Health Care. 

From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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