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Revenue Integrity Analyst

Cleveland, OH, US


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req#: 275329
Location: Cleveland, OH

Facilities: Remote Location,

Professional Area: Finance

Department: 2700 RCM Charge Capture-Finance

Job Code: T98680

Schedule: Full Time

Shift: Days

Revenue Integrity Analyst – RCM Charge Capture  

Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.   

Revenue Integrity Analysts are responsible for coordinating, implementing, and maintaining the Epic Charge Description Master (CDM) initiatives and processes with a focus on accuracy, revenue cycle integrity, and compliance with third-party payor requirements. This role ensures the overall integrity of the CDM and related components (cost center assignment, billing codes, price, RVU, etc.).  

A caregiver in this position works Days, from 8:00am—4:30pm.  

A caregiver who excels in this role will:  

  • Assist revenue producing departments (Institutes, regional hospitals, etc.) with charge capture, charge reconciliation, billing, denials, and compliance issues in accordance with regulations.  

  • Help to ensure optimal cash flow through the resolution of assigned billing and error work queues. 

  • Be responsible for the oversight and updating of the Epic Charge Description Master and associated functions within the Revenue Integrity Department of RCM.  

  • Provide support for implementations, ongoing maintenance, and optimization of Epic CDM and charging functions. 

  • Be responsible for the remediation of assigned Epic system CDMs, charge capture methods, and error work queues. 

  • Work with assigned revenue producing departments to ensure the ongoing consistency of the CDM including accurate descriptions, coding, additions, deletions, pricing, RVUs and any other changes. 

  • Collaborate with managerial and supervisory caregivers to ensure regulatory billing with correct coding on accounts. 

  • Maintain a working knowledge of revenue cycle process and Epic tools (e.g., work queues, reports, etc.) to aid in the implementation of regulatory standards that assist the health system in cash production while accurately complying with billing guidelines.  

  • Monitor compliance with corporate, federal, and state guidelines. 

  • Maintain timely turnaround of all CDM requests in accordance with established Service Level Agreements (SLA) or regulatory deadlines.  

  • Participate in ongoing coordination and resolution of revenue issues as they arise. 

  • Analyze reports and work queues to determine areas of improvement and appropriate plans of action.  

  • Disseminate CMS updates to health care providers as they relate to billing for drugs, implantable and/or other pass-through eligible items, ensuring the necessary changes are made to the CDM within the time frame for accurate and compliant billing. 

  • Remain current with updated coding and billing regulations. 

  • Develop and maintain strong working relationships with internal and external customers. 

  • Maintain high productivity and quality with minimal supervision. 

Minimum qualifications for the ideal future caregiver include:  

  • Associate’s degree in accounting, finance, business, healthcare operations or a related field.  

  • Three or more years of healthcare-related experience. Additional related experience may substitute the degree requirement.  

  • Epic Charge Description Master (CDM) management certification required or must be obtained within six months of hire.  

  • Yearly continuing education. 

  • Extensive knowledge of CPT/HCPCS, uniform billing revenue coding, modifiers, billing regulations and APCs.  

  • Understanding of the CDM and its relationship to related areas, such as the general ledger, cost accounting, productivity, cost reporting and budgets.  

  • Ability to understand and analyze payor regulations and the impact of the CDM on reimbursement and coding guidelines.  

  • Ability to collaborate with customers and guide decision-making on CDM-related topics. 

  • Ability to effectively present information to management, facility groups and individuals.  

Preferred qualifications for the ideal future caregiver include:  

  • Clinical or professional certifications and licenses: Licensed Vocational Nurse (LVN), Registered Nurse (RN), Respiratory Therapist (RT), Medical Technologist (MT), Registered Pharmacist (RPH), Certified Professional Coder-Hospital (CPC-H), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS). 

  • Charge capture experience.  

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/  

 

Physical Requirements:

  • Ability to communicate and exchange accurate information. 

  • Ability to perform work in a stationary position for extended periods.  

  • Ability to work with physical records or operate a computer or other office equipment.  

  • In some locations, ability to travel throughout the hospital system.  

  • In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

  • Follows standard precautions using personal protective equipment as required.

Pay Range

Minimum hourly: $27.65

Maximum hourly: $42.17

The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic’s benefits package, which includes among other benefits, healthcare/dental/vision and retirement.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System’s Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

 

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

Please review the Equal Employment Opportunity poster

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities

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