Position Summary: We have an exciting opportunity to join our team as a Sr. Revenue Integrity Analyst.
In this role, the successful candidate reporting to the Assistant Director, Revenue Integrity & Documentation at the Perlmutter Cancer Center (PCC), the Sr. Revenue Integrity Analyst is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection. The Sr. Revenue Integrity Analyst will be responsible for reviewing and interpreting Managed Care contracts and fee schedules to maximize reimbursement for all PCC locations. Additionally, the position will be responsible for monthly audits of Finance reports ensuring charge accuracy and billing.
Conduct audit and review activities to improve the revenue cycle, claims production and coding integrity. Reviews data and systems to target areas of improvement.
Maintains compliance with state, federal, and other third-party payer billing and reimbursement guidelines. Serves as a subject matter expert and in a consultative role to various levels of customers; works closely and collaboratively with PCC operations.
Plans revenue management strategies as identified in data/report analyses to ensure consistency/standardization, to identify improvement opportunities, and to facilitate appropriate education.
Read, interpret, and apply policies and procedures; draw conclusions, and make recommendations
Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities.
Prepares analyses and reports/recommendations based on activities.
Perform audits of gross charges on a monthly and Ad-Hoc basis.
Reviews, develops, implements, evaluates, and revises charge guidelines to optimize revenue management; effectively implements recommendations and monitors results. Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer
Interprets Managed Care contracts and fee schedules to ensure accurate reimbursement in Epic.
Extracts and compiles data from various system sources to develop sound analyses leading to potential revenue cycle opportunities, including analyses related to CDM set-up, charge capture, billing and/or patient financial services.
Maintains collaborative relationships with internal and external teams to ensure integration and alignment of department priorities.
Provides guidance and education related to billing and charge capture of services to multiple staff levels; facilitates proper recording of transactions in compliance with state, federal, and other third-party payer guidelines.
Conducts and leads special projects and special studies to facilitate revenue management as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, etc.
Performs other duties as assigned.
Minimum Qualifications: To qualify you must have a Bachelor's degree and 7+ years of auditing, consulting, and/or revenue cycle management experience in a healthcare environment. Strong interpersonal communication and presentation skills, effectively presenting information to management, groups and individuals. Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle.
Preferred Qualifications: CPC Certification
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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Internal Number: 67260556
About NYU Langone Medical Center
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.