Revenue Integrity Analyst

• Position:Revenue Integrity Analyst
• Hourly Pay Range: $30.46-$45.69/hour. The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
• Location: Skokie, IL
• Full Time/Part Time: Full-time
• Hours: Monday-Friday 8:00am-5:00pm

Job Summary

Assign ICD-10 and/or CPT-4 codes and appropriate modifiers to outpatient types for all facility coding on all claims that do not clear ECARE. Analyze and assist in ECARE edit resolution, research billing and denial issues, resolve claim errors and develop, implement and maintain measures for process improvement. Assist Sr. Analyst with special projects that identify revenue opportunities and areas of denial reduction. Work in daily work queues, department specific tasks, and Revenue Integrity helpline.

What you will do:

• Recommends appropriate ICD-10, CPT, and HCPCS codes to medical record documentation by applying physician specialty coding rules, third party payor guidelines, APC billing rules, and Medicare Local and National Medical Review Policies.
• Works with Medical Group HIM, clinic personnel, HIRS, to interpret medical record documentation and/or documentation summary as necessary.
• Review Hospital Billing E-care errors coming from the Billing office and resolve the issue by documenting the results.
• Collaborate with CDM on identified missing codes and missing charges.
• Provide coding education service with Independent Physicians and assist with coding issues.
• Works collaboratively with Billing, HIRS, overseeing provider/specialty and Denials Management Team to review information on coding/billing denials and reimbursements by carriers, provide medical records for appeals, or recommend necessary billing corrections. Identify issues and analyze trends by payor mix to provide education and enhance charge capture opportunities.
• Conducts face-to-face meetings with hospital staff, Administrative/Site Directors/Assistant Vice President and physician, if needed/requested, to discuss operational/coding issue results.
• Provides feedback to Manager/Director that identifies inefficient coding/operational processes.
• Communicate to NCCI or CMS with questions or to dispute NCCI or OCE edits.
• Provide assistance to Customer Service and HIRS departments to resolve patient coding/coverage questions.
• Assists with related special projects as assigned by Manager/ Director.
• Researches multi-specialty coding and billing questions received from the Coding Help-line/email for Endeavor provider/staff and provides verbal or written response as appropriate. Maintains emails of all questions received and answers provided.
• Works on special projects with the Hospital Billing Business Office and/or the Finance Department to perform reimbursement analysis functions as assigned by Manager/ Director.
• Works with the Director of Coding and Compliance of Education Sessions. Performs presentations as assigned.
• Continuous monitoring of CMS/NGS coding regulations and updates as is relates to coding and billing issues.
• Maintains, on a quarterly basis, the CBO Pulse webpage with any new regulations or updates as it relates to coding and billing.

What you will need:

• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certified upon hire or Certified Coding Specialists (CCS) certified or eligible with 2 years experience and 6 months to pass exam.

Benefits:

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.