[Remote] Revenue Integrity Analyst, CDM, 100% Remote, M-F

Note: The job is a remote job and is open to candidates in USA. Duke Health’s Revenue Integrity Analyst supports its Charge Description Master team’s revenue integrity and charge capture optimization initiatives. The role reviews pre-bill accounts, identifies and corrects charge issues, audits documentation, and provides analytical support for payer reimbursement, contract compliance, and education efforts.

Responsibilities

• Responsible for conducting quality control audits to ensure data/documentation integrity, and trending of accounts that qualify for Revenue Guardian edits. This includes compilation by clinical department for education deliverables. (20%)
• Serves as Subject Matter Expert to leadership on issues related to Revenue Integrity. (10%)
• Preparation of monthly reports and educational presentations for clinical departments and Revenue Manager teams. Compilation of data trends will be monitored to validate documentation improvement initiatives and optimizing charge capture activities. (20%)
• Follow up with appropriate health team members to ensure accurate and complete documentation in the medical record. Works collaboratively with the appropriate operational leaders to develop provider and service line education strategies to promote complete and accurate clinical documentation; using root cause analysis to correct negative trends, behaviors and able to impart this knowledge to provider and other health team members. (20%)
• Review charges and payments for accuracy from contracted payers and management of appeals process with each assigned payer, in both the hospital and clinic setting. Identify revenue gains (gross dollars/percentage for net) through various reporting tools. (20%)
• Perform other related duties incidental to the work described herein. (10%)

Skills

• Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related degree
• 3 years of experience related to coding is required
• Coding certification (e.g. CPC, CCS, RHIA, RHIT) is required
• In-depth knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements
• Revenue Cycle experience
• Strong oral and written communication skills
• Research-oriented with ability to critically analyze and reason large amounts of data
• Charge capture, reporting, and analysis experience is preferred

Benefits

• 100% Remote

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