Revenue Charge Integrity Analyst

Revenue Charge Integrity Analyst

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Job Summary

The Charge Integrity Analyst plays an essential role in Michigan Medicine's Revenue Cycle. Analysts maintain charge and charge-related functionality, provide system and departmental support, and help to ensure the integrity and accuracy of patient accounts.

The core functionality of Charge Integrity is to maintain the hospital and professional charge master and fee schedules. Analysts are expected to remain current on regulatory updates in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee. Analysts work with a large variety of Revenue Cycle and non-Revenue Cycle teams to support charge capture functionality and ensure proper charging practices. Daily tasks include monitoring and working work queues, analyzing charts, addressing charging and workflow issues, investigating root cause, propose and support solutions. Projects are assigned to ensure proper build, testing, training, and monitoring of system upgrades and optimizations. Analysts are expected to work closely and promote an atmosphere of teamwork with other members of Charge Integrity as well as their peers in Revenue Cycle, to achieve department objectives and provide stellar customer service.

This position requires very strong analytical skills. Analysts must demonstrate the ability to pull and analyze data and documentation, determine root causes, and recommend solutions based on standard coding and billing best practices. Strong excel skills are essential. Knowledge of clinical and hospital workflows, compliance, MiChart, and Epic certifications are beneficial. Analysts must be organized, detail oriented, and work well independently.

Responsibilities

• Ensure that the Charge Master is built and maintained in accordance with hospital policies, AMA guidelines, Federal and State law, National Uniform Billing Committee standards, CMS and other regulatory and payor mandated charge capture guidelines, including revenue code, CPT, HCPCS, and modifiers.

• Maintain Coding Certification including staying current on articles, newsletters, memos and attend seminars to successfully oversee the Charge Master and ensure its proper use.

• Audit, utilize, and maintain Charge Master data in FinThrive and in the Epic EAP master file.

• Set hospital rates following department policy, using standardized pricing algorithms, available benchmarking and other rate setting tools.

• Work with other Charge Integrity team members and MiChart CORE team as assigned to maintain a variety of MiChart files and databases.

• Maintain and support all charging methods including: Charge Capture Preference Lists, Bedside Procedure SmartForms, Clinic Performed Orders/Procedures, LOS, SmartSets and other charge capture tools.

• Support departmental modules and workflows that interface/support charge capture.

• Maintain organized files of all critical correspondence, charge and fee schedule changes.

• Participate in the design, build, and testing of new and existing rules that track and identify potential charge errors.

• Assist in developing and establishing new departments by creating charging workflows, ensuring correct charge capture and reconciliation support.

• Work with Clinical Departments, Revenue Cycle peers, and other MM teams to ensure proper charge generation from clinical systems. Provide support as needed to Finance and other Revenue Cycle departments.

• Work MiChart Workqueues. Monitor WQs for spikes and assist with identifying root causes. Identify areas of improvement and propose solutions to increase efficiency.

• Act as liaison between Billing and Clinical Departments to investigate and resolve issues.

• Participate in research, build, test script development, testing, training and go-live support of periodic MiChart Upgrades, new module implementations, system optimizations and other organizational projects.

• Support Revenue Cycle initiatives by creating reports, analyzing data, and creating/presenting SBARs as necessary.

• Required Qualifications

• Associate's degree in Business Administration, Healthcare Administration, Health Information Management, Health Information Technology or equivalent combination of education and work experience.

• Experience with reimbursement, billing, medical coding and compliance related to a large medical institution.

• Experience as a Certified Coder, Charge Master Administrator, Revenue Integrity Specialist, Epic Analyst, Senior Biller, Medical Compliance Officer or equivalent title.

• Exceptionally strong problem solving, analytical and organizational skills.

• Ability to research root cause, recommend solutions and support improvements.

• Extensive experience with Electronic Health Record, clinical and billing workflows (such as Epic or Cerner).

• Extensive experience with MS Office tools with strong emphasis on advanced Excel knowledge.

• Self-motivated and detail oriented with the ability to work independently.

• Excellent communication with the ability to articulate both written and verbal communication(s).

• Strong customer service focus.

• Great attendance record.

• Desired Qualifications

• Bachelor degree in Business Administration, Healthcare Administration, Health Information Management, Health Information Technology or equivalent combination of education and experience.

• RHIT, CPC certification or equivalent combination of education and experience.

• Experience with University systems including, Epic EHR (MiChart), Tableau, Finance BI, and SlicerDicer

• Knowledge of payer websites, compliance tools, and billing resources.

• Proficiency in Microsoft PowerPoint, Access, Visio.

• Hospital Billing experience within the last 5 years.

• Knowledge of University Health System policies, procedures and regulations.

• Knowledge of or experience in the delivery of patient care and front-end workflows.

• Experience performing financial and billing data reviews, claim and medical record audits, documentation analysis, and identifying areas of financial risk.

• Experience interpreting and applying CMS and other payer guidelines and regulations.

• Why Join Michigan Medicine?

• Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

• What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day

• 2:1 Match on retirement savings

• Modes of Work

• Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

• Background Screening

• Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

• Job Opening ID

• 283564

• Working Title

• Revenue Charge Integrity Analyst

• Job Title

• Revenue Chrg Intgrty Analyst

• Work Location

• Michigan Medicine - Ann Arbor

• Ann Arbor, MI

• Modes of Work

• Mobile/Remote