Revenue Integrity Analyst

Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key?

We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees love their work here. Many have been with us from the very beginning. Because we’re physician-owned, we understand the value of having a well-trained, well-resourced staff. When it comes to procedural healthcare, experience matters.

Lubbock Heart & Surgical Hospital is committed to providing better outcomes for our employees!

• Great Benefits – Medical, Vision, Dental, PTO & 401K
• Opportunities for Advancement
• Career Ladder for RNs, LVNs, & CSTs
• Consumer discounts through Perks
• Family Atmosphere
• Free CEUs through Cornerstone, our online training system

We are looking for a dedicated Revenue Integrity Analyst like you to join our Lubbock Heart team.

• →Interpret accurate reports, compile data and work papers to support revenue cycle workflows to assist with timely and accurate charge capture and billing.
• →Audit, identify, and trend payor denials, recoupments, and underpayments.
• →Audit and identify patient credit balances and take appropriate action in the payment and billing systems.
• →Work with clinical and business system development and maintenance of data.
• →Work collaboratively with all departments to assist in compliant and appropriate business practices.
• →Perform Charge Capture reviews, audits and research.
• →Revenue Cycle Analyst will be expected to be a resource for the entire Revenue Cycle and its operations.
• →Identify gaps in processes, recommends solutions, and assists Director of Revenue Cycle Management in implementation of revenue cycle improvements.
• →Preform reviews and analysis of documentation in EHR and provides education to ensure appropriate document standards according to Medicare standards.
• →Provides backup support for HIM documentation functions.
• →Educate clinical department and providers on quarterly coding and billing updates.
• →Excellent written and communication skills with the ability to write, present, and explain recommended materials in a clear, concise and organized format.
• →Support different computer systems including Cerner.
• →Proven analytical skills.
• →Maintain a culture of compliance, ethics and integrity especially in the rate-setting process.
• →Generate reports, monitors charges, discharged not final billed, work queues, denial reports, other revenue cycle related reports to assist management and revenue cycle team in the timely charge capture and billing efforts.
• →Research and analyze reimbursement practices, compiles data in an organized format and makes recommendations on charge capture changes.
• →Research and monitor codes on services, procedures, supplies, injections, medications and modifiers.
• →Exhibit and maintains an understanding and application of CPT, HCPCS and CMS regulations and guidelines.
• →This detail level analysis involves root cause analysis and entails looking at patient account level detail.
• →Assist with implementation of new charges and meet with departments as needed.
• →Interact with leadership, department managers and facility staff regarding CDM compliance and related financial issues.
• →Research and processes patient refunds. • POC for escalated in-person and phone inquiries. • Review and audit revenue processes and charge capture effectiveness to facilitate optimal performance and efficiencies.
• →Assist with data analysis and research for any and all charge capture efforts. Propose action plan for resolution of issue as it pertains to charge capture/CDM.
• →Works with Coding and all other departments to ensure revenue integrity in charge capture processes.
• →Validate UB revenue codes, type of service codes to ensure accurate assignment and smooth workflows on billing forms.
• →Coordinate assignment of codes.
• →Work daily work queues to resolve - bill holds - for charge related issues assigned to the revenue integrity unit in the charge and work queues.
• →Daily review of claims held in charge and Discharged Not Final Billed applications. Distribution of these charges related issues to the proper department.
• →Assist in maintaining the HB Charge Contact list for distribution to billing, coding and PFS groups.
• →Assist with report findings from the assigned work queues, erroneous or missing charge postings with following up analysis, development, and implementation of recommendations and actions plans to minimize late or missing charges.
• →Work with the Revenue Cycle Director to document and report findings and work with Performance Improvement team to develop recommendations and corrective actions.
• →Support the remediation process within third part vendor software to the extent they relate to charge capture and revenue integrity concerns.
• →Assists with analytical support to: process analysis, denial analysis, charge lag analysis, underpayment analysis and missing charge analysis and all other aspects of revenue cycle. • Performs other duties as assigned by management.

• An Associate’s Degree
• Three years of experience in revenue cycle or data analysis
• At least one year of experience in both facility and provider billing and coding
• Experience with Cerner
• Coding Certification

• Flexible Scheduling
• No mandatory overtime

Lubbock Heart & Surgical Hospital specializes in the care of cardiac, orthopedic, nephrology, urology, and general medical patients.  We are also a highly active inpatient center mainly centered on surgical procedures that include cardiothoracic, orthopedic, urology, and general surgery.  We have a 24-hour Emergency Department with 5 fully equipped ED rooms, 4 fully operating OR rooms, 4 cardiac catherization labs with 1 electrophysiology room, 11-day surgery rooms, 58 acute care beds spread over three units, and 16 cardiac critical care rooms.  We pride ourselves on giving the best overall care possible to our patients and on our family style atmosphere that includes everyone: patients and their families, physicians, and our employees.