高级收入合规分析师
Senior Revenue Integrity Analyst
职位类别：
收入周期
工作班次/时间安排：
8小时上午-下午
Northeast Georgia Health System 始终致力于提升我们社区的健康水平。
职位简介
高级收入完整性分析师提供在收费捕获、CDM应用、合规性和报销方面的专业知识。高级收入完整性分析师领导审计工作，支持治理，并在临床部门推动收入优化计划，同时确保符合CMS和付款方的要求。
最低职位资格
- 证书或执照：
- 教育要求：学士学位
- 最低经验：5年以上医院收入周期、收费或CDM经验
- 其他：相关证书和实际工作经验的组合可替代所需学位。
优先职位资格
- 优先证书或执照：CPC、CCS、RHIT/RHIA、Epic认证
- 优先教育要求：
- 优先经验：
- 其他：
职位特定知识、技能和能力
- 熟悉CPT/HCPCS和报销流程
- 精通CDM结构和临床应用
- 强大的审计和合规背景
- 能够分析收费问题的财务影响
- 具有流程重新设计和优化的经验
- 高级Excel和数据分析技能
- 能够领导培训和教育项目
- 在临床和高管团队之间具有良好的沟通能力
- 熟悉CMS、医疗补助和付款方规则
- 具有仪表板和报告经验
核心任务和职责
- 监控部门收费捕获准确性，确保对工作队列和对账报告进行全面分析。
- 识别收费捕获缺口、流程问题和系统性收入损失风险。
- 为临床部门提供指导、培训和教育。
- 与CDM团队合作进行更新并提出改进建议。
- 进行收费前/后审计，验证收费映射和计费规则。
- 分析影响报销、合规性和财务表现的趋势和根本原因。
- 量化面临风险的收入，评估收费问题的财务影响，并制定纠正措施计划以优化收入计划。
- 确保符合CMS和监管要求。
- 支持CPT/HCPCS年度更新
- 与编码、IT、财务、合规和管理层跨职能协作，解决这些问题并改进流程
查看英文原文
Job Category:
Revenue CycleWork Shift/Schedule:
8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health of our communities.
About the Role:
Job Summary
The Sr. Revenue Integrity Analyst provides subject matter expertise in charge capture, CDM application, compliance, and reimbursement. The Sr. Revenue Integrity Analyst leads audits, supports governance, and drives revenue optimization initiatives across clinical departments while ensuring alignment with CMS and payer requirements.
Minimum Job Qualifications
- Licensure or other certifications:
- Educational Requirements: Bachelors Degree
- Minimum Experience: 5+ years hospital revenue cycle, charge capture, or CDM
- Other: A combination of relevant certification(s) and demonstrated work experience may substitute for the required degree.
Preferred Job Qualifications
- Preferred Licensure or other certifications: CPC, CCS, RHIT/RHIA, Epic Certification.
- Preferred Educational Requirements:
- Preferred Experience:
- Other:
Job Specific and Unique Knowledge, Skills and Abilities
- Advanced knowledge of CPT/HCPCS and reimbursement
- Expertise in CDM structure and clinical application
- Strong auditing and compliance background
- Ability to analyze financial impact of charge issues
- Experience with workflow redesign and optimization
- Advanced Excel and data analysis skills
- Ability to lead training and education initiatives
- Strong communication across clinical and executive teams
- Knowledge of CMS, Medicaid, and payor rules
- Experience with dashboards and reporting
Essential Tasks and Responsibilities
- Monitor departmental charge capture accuracy to ensure thorough analysis of work queues and reconciliation reports.
- Identify charge capture gaps, workflow issues, and systemic revenue loss risks.
- Provide guidance, training, and education to clinical departments
- Partner with CDM team on updates and recommend improvements
- Conduct pre/post bill audits to validate charge mappings and billing rules.
- Analyze trends and root causes impacting reimbursement, compliance, and financial performance.
- Quantify revenue at risk and assess the financial impact of charge and develop corrective action plans to optimize revenue initiatives.
- Ensure CMS and regulatory compliance
- Support CPT/HCPCS annual updates
- Collaborate cross-functionally with Coding, IT, Finanace, Compliance and leadership to resolve issues and improve processes.
- Support governance committees
- Develop reports and dashboards and deliverdata-driven recommendations to leadership.
- Performs other duties as assigned.
Physical Demands
- Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
- Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
- Vision: Moderate, Frequently 31-65% of time
- Kneeling/Stooping/Bending:Occasionally 0-30%
- Standing/Walking:Occasionally 0-30%
- Pushing/Pulling:Occasionally 0-30%
- Intensity of Work: Frequently 31-65%
- Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving
Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.
NGHS: Opportunities start here.
Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
Originally posted on Himalayas