Revenue Integrity Analyst III
Stanford Health Care – University HealthCare Alliance
Newark, CA
University HealthCare Alliance dba Stanford Medicine Partners is looking for an amazing Revenue Integrity Analyst III to join our rapidly growing team!
SMP prides itself in offering exceptional service and patient care. Stanford Medicine Partners with Stanford Health Care to provide individualized and convenient care with access to Stanford specialists and technology.
Join our team and start making a difference today!
A Brief Overview
The revenue integrity analyst conducts a deep dive into the new clinic legacy system around scheduling and billing workflow to support the transition and integration of billing into the Epic Resolute module. An extensive review of their CPT and ICD10 will be conducted to create future workflows and educational opportunities to the providers prior to joining UHA. The analyst will also support the transition in person or at home base by reviewing the coding and documentation and providing real time education and/or training to the Providers. The analyst will also perform charge reconciliation and posting into the Epic resolute system and own the transition work queues.
For clinics transitioning to the Epic EMR, the analyst is responsible for researching and providing input to the Epic preference list build and confirming that the build in place is dropping charges as expected from the Epic Care build. Responsible for documentation review and identifying any educational or training opportunities. Collaborates with the SHC Digital Solutions team.
What you will do
Data Analytics and Charge Capture and Coding
- Resolute Shell: With direction from the team manager, to perform analysis of legacy system to include: scheduling templates (confirm service provider templates), how are charge documented and dropped, charge and claim edits, reconciliation reports, open encounter reporting.
- Perform and assist reconciliation between the legacy and Epic batches with the charge capture staff.
- Works closely with department Manager in monitoring assigned activity such as reviewing all tracker of issues associated to registration, scheduling and/or provider education.
- Responsible for understanding documentation in clinic legacy system – new groups.
- Provide system, coding and documentation training to providers in the EPIC EMR to include on-site and/or home base support during Go-Live. Review of all encounters for missed revenue and high-level coding.
- Review charge review and coding review work queue.
For new groups and EMR transition, responsible for:
- Review of documentation vs. procedure codes dropped to billing
- Appropriateness of procedure codes
- Leveling the E/M
- Create trackers for communication within the revenue cycle, revenue integrity and clinic operations
- Create power point presentation to share with other departments: Pre-Go Live and Post-Go Live information.
- Create any training/education presentations and present to the physicians/providers.
- Create training material and train the revenue cycle for the operational handoff.
- Keeps abreast of current changes in coding and reimbursement requirements for government programs and other third-party payers.
- Adheres to safety, P4P’s (if applicable), HIPAA and compliance policies.
- Performs other duties as assigned and participates in organization projects as assigned.
Qualifications
- High School Diploma or GED
- 5+ years to 7 years recent coding experience or applicable physician practice setting a plus; or an equivalent combination of education and experience
- Advanced skills in Excel, Power Point, Visio products
Required Knowledge, Skills and Abilities
- Strong verbal/written communication and listening skills; including excellent interpersonal skills and telephone communication.
- Ability to maintain composure during challenging interpersonal interactions.
- Ability to effectively organize and prioritize tasks in order to complete assignments within the time allotted and maintain standard workflow.
- Ability to establish and maintain effective working relationships with patients, medical staff, coworkers, and the public.
- Proficiency in the operation of a computer using Microsoft Office Suite (Word, Excel, PowerPoint, etc.), databases, graphics, presentation software, electronic calendars and email.
- Skill in identifying and resolving problems.
- Ability to interpret, adapt and apply guidelines and procedures.
- Demonstrated knowledge of medical coding (including CPT4, HCPCs, ICD-9), with EMR experience.
- Knowledge of Medicare, MediCal, commercial and managed care insurance preferred.
- Strong verbal/written/organizational/customer service skills.
- Ability to work independently with excellent follow-through and maintain confidentiality as required.
- Demonstrated ability to access state and federal websites for coding, billing and reimbursement information.
Licenses and Certifications
- CCA - Certified Coding Assoc
- CCS - Certified Coding Specialist
These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family Experience
Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars, from the patient and family’s perspective:
- Know Me: Anticipate my needs and status to deliver effective care
- Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
- Coordinate for Me: Own the complexity of my care through coordination
Job Type: Full-time
Pay: $44.13 - $57.36 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
