Revenue Integrity Analyst
Facility: Luminis Health
Location: Annapolis, MD
Posted Date: March 2, 2023
Not ready to apply, or just want to learn more about our company and the hottest job opportunities, please join our Talent Community.
Title: Analyst, Revenue Integrity
Department: Finance, Revenue Cycle Management
Reports To: Manager – Revenue Cycle, Revenue Integrity
Cost Center/Job Code:
FLSA Status: Exempt
The candidate is responsible for overseeing and maintaining specifically assigned system Charge controls, developing enhanced charge reconciliation functions at the department level, CDM maintenance, and governmental updates related to Revenue Integrity and Compliance. Provide all levels of support to Luminis Health facilities to ensure revenue recognition, including issue resolution for assigned areas of responsibility. Responsibilities are to resolve issues and assist others with resolving problems related to Revenue Integrity. Position communicates to internal and external users all corrections, changes and provides education to the facilities and internal customers. Reviews system charge reports and identifies trends, educational needs, workflow problems, and potential system issues. Generates monthly reconciliation reports and facilitates daily/weekly calls to review the data with the department’s heads, hospital administrators, and CBOs. Ensures that any reconciliation issues are resolved promptly. The position will require reviewing specific account details to support other employees, CBO staff, or Administration when there are questions regarding the charge reconciliation process. They will analyze revenue cycle systems, including reporting data to maintain acceptable reconciliation performance, compliance, user satisfaction, and help develop greater efficiencies to identify charge enhancement opportunities. This position will determine the need for claims to be adjudicated with no further review, review records, or facilitate an onsite audit at the hospital. Develops and documents hospital claims review and audit policies. Collaborates with Luminis Health facilities to provide clinical policy representation at meetings to ensure that decisions, which affect claim processing, are appropriate and will result in cost-effective, efficient, and accurate claims payment. The analyst will investigate provider aberrant/fraudulent billing practices utilizing paid claim data and review medical records. Provides education to employees and provider offices as needed to understand correct claim coding, use of CPT, ICD9, ICD-10 HCPCS, etc.
Essential Job Duties:
Required Minimum Experience:
Knowledge, Skills, Abilities:
Working Conditions, Equipment, Physical Demands:
Light work. Exerting up to 20 pounds of force occasionally, up to 10 pounds of force frequently, and a negligible amount of energy constantly to move objects. If the use of arm and leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
There is reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
Create your talent profile to receive customized job alerts and the latest company information.
Current employees should click on the button to search jobs, login and manage job agents, check application status, and more.
Important Information about CPR (BLS) requirements for Luminis Health. (Note: this downloads a word document)
2001 Medical Parkway
Annapolis, Maryland 21401
Nurse Advice Line: