Revenue Integrity Analyst

February 24

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Ensemble Health Partners

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Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

Revenue cycle consulting • Revenue cycle assessments • Revenue recovery • Revenue Cycle • EPIC

10,000+ employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 Private Equity Round on 2022-03

📋 Description

• Evaluate current charging processes to diagnose the root cause of any charge inefficiencies and ensure standard charge practices are implemented. • Analyze changes to coding and billing rules and regulations and using independent decision making to ensure appropriate updates to CDM and charge processes are implemented. • Prepare and present quarterly and annual CPT/HCPCS changes, annual pricing updates and provide client education material and presentation. • Conduct thorough research to ensure the Charge Description Master (CDM) is maintained regularly. • Collaborate with stakeholders in revenue enhancement projects including Denial Management, APC Billing and/or other committees as needed. • Provide leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives. • Conduct thorough analysis of billing errors and denial data to diagnose root causes. • Responsible for problem solving and resolution of complex claim edits. • Stay up-to-date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively share knowledge with the team. • Serve as subject matter expert (SME) of charge capture methodologies and help investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff. • Rounding on client revenue leaders on a quarterly basis to review questions concerning charge reconciliation, charge processes, CDM.

🎯 Requirements

• 3-5 years related experience required • Excellent knowledge of Epic, Excel and SQL queries. • Working knowledge of CPT & HCPCs coding guidelines. • Excellent computer, proofreading, and written and verbal communication skills. • Excellent interpersonal skills including the ability to communicate effectively with CHP internal and external customer base. • Ability to work independently, proactively with limited supervision and also as a team player when called upon. • Ability to work under pressure. • Ability to maintain the security of confidential information.

🏖️ Benefits

• Bonus Incentives • Paid Certifications • Tuition Reimbursement • Comprehensive Benefits • Career Advancement