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Revenue Integrity Analyst 1

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Baylor Scott & White Health

2mo ago

  • Internship
    Full-time
    Off-cycle Internship
  • Accounting & Tax
    Healthcare
  • Dallas

AI generated summary

  • You need a Bachelor's degree or 4 years' experience, less than 1 year of experience, strong communication skills, Excel proficiency, organizational skills, and knowledge of billing systems preferred.
  • You will manage charge capture processes, conduct audits, ensure billing accuracy, maintain CDM compliance, educate teams, and support operational success for assigned service lines.

Requirements

  • * EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
  • * EXPERIENCE - Less than 1 Year of Experience
  • * Exceptional verbal and written communication skills, manifesting in the ability to create communications that are informative, concise, and free of spelling and grammatical errors.
  • * Experience managing small sized projects preferred.
  • * Ability to execute tasks through an organized and detailed approach.
  • * Advanced knowledge of Excel to include formulas, functions, and pivot tables in order to examine large data sets and draw conclusions
  • * Ability to work alone and as a part of a team in a fast-paced, unpredictable, and deadline environment
  • * Exceptional organizational skills
  • * Proficiency in researching complex questions and providing recommendations
  • * Self-motivated with ability to identify and resolve issues and advance personal knowledge
  • * Ability to understand, interpret, establish impact of and respond to complex instructions from state and federal governing entities.
  • * Epic Hospital Billing, Professional Billing, and Chargemaster experience preferred.

Responsibilities

  • Assists in developing and maintaining a standardized charging methodology across all facilities for assigned service line(s) and partners with IS to design, build, validate, and test workflows impacting the Revenue Cycle. Develops detailed knowledge of charge capture workflow and mechanisms in order to support the IS teams with build required to achieve anticipated charging outcomes.
  • Manages small charge capture projects and initiatives for assigned service line(s) with some oversight. Identifies problems by evaluating business requirements, examining data, negotiating organizational consensus, and synthesizing key messages for communication to all stake holders. Collaborates with numerous teams to support charging and billing accuracy efforts.
  • Performs charge capture audits and education with some oversight. Designs, creates, and conducts audits and data-backed assessments to evaluate compliance with BSWH policies, procedures, and applicable laws related to charging practices for assigned service line(s). Formulates recommendations and corrective actions based on audit findings. Compiles written audit report detailing risks and financial impacts of deficiencies and proposing solutions for mitigation with some oversight.
  • Examines accounts, claims, and clinical documentation for charge capture and billing quality and accuracy. Interprets documentation from medical records to validate charges. Provides feedback and education, as appropriate, depending on findings.
  • Ensures the accuracy of the Charge Description Master (CDM). Evaluates critical data elements in the CDM to ensure adherence to CMS, AMA, third party payor, and other applicable state and federal guidelines across related departments. Validates all changes for data integrity.
  • Reviews, interprets, and implements any coding and billing changes impacting the assigned service line(s) related to the quarterly and annual CPT update processes. Evaluates clinical processes to establish what changes are required to accommodate updated coding and billing regulations.
  • Provides charge reconciliation education to assigned service line(s) and associated clinical departments, with oversight as needed. Performs frequent audits to ensure department compliance.
  • Helps the success of new department, facility, service, workflow, or methodology go-lives by performing charge capture audits to ensure go-live success and rounding with department leadership and key stakeholders to ensure operational success while providing an avenue for questions and escalations.
  • Performs other position appropriate duties as required in a competent, professional, and courteous manner.

FAQs

What is the role of a Revenue Integrity Analyst 1?

The Revenue Integrity Analyst 1 manages small projects and less complex service lines, ensuring that charge capture activities adhere to BSWH processes, policies, and applicable guidelines.

What are the essential functions of this role?

The essential functions include assisting in charge capture methodology development, managing charge capture projects, performing audits and education, ensuring CDM accuracy, and providing charge reconciliation education, among others.

What qualifications are required for this position?

A Bachelor's degree or 4 years of relevant work experience is required, along with less than 1 year of experience in a related field.

What key skills are desired for this role?

Exceptional communication skills, advanced knowledge of Excel, organizational skills, research proficiency, self-motivation, and the ability to interpret complex instructions are desired.

Is experience with Epic Hospital Billing and Chargemaster preferred?

Yes, experience with Epic Hospital Billing, Professional Billing, and Chargemaster is preferred.

What benefits are included in this position?

Benefits include immediate eligibility for health and welfare benefits, a 401(k) savings plan with a dollar-for-dollar match up to 5%, tuition reimbursement, and PTO accrual starting on Day 1.

How does this role contribute to the success of the Revenue Cycle?

This role supports charging and billing accuracy by managing charge capture initiatives, auditing compliance, and ensuring that all processes align with state and federal guidelines, thereby enhancing overall revenue integrity.

Is remote work allowed for this position?

Yes, remote work is supported but in a hybrid format.

What type of projects will the Revenue Integrity Analyst 1 manage?

The Analyst will manage small charge capture projects and initiatives for assigned service lines, with some oversight.

Will there be opportunities for professional development?

Yes, the position includes resources like tuition reimbursement for continued education and professional development opportunities.

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Baylor Scott & White Health

Changing Healthcare for the Better.

Science & Healthcare
Industry
10,001+
Employees
1903
Founded Year

Mission & Purpose

As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,100 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com.

Culture & Values

  • We serve faithfully

  • We never settle

  • We are in it together

  • We make an impact