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Revenue Integrity Analyst

Company: Children---s Hospital Colorado
Location: Aurora
Posted on: July 16, 2019

Job Description:

Job Description Why Work at Children's.... Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Founded in 1908, Children's Colorado is a leading pediatric network entirely devoted to the health and well being of children. Continually recognized as one of the nation's outstanding hospitals by U.S. News & World Report, Children's Colorado is known both for its nationally and internationally recognized medical, research and education programs as well as the full spectrum of everyday care for kids throughout Colorado and surrounding states. With more than 1,000 healthcare professionals representing the full spectrum of pediatric specialties, Children's Colorado Network of Care includes its main campus, 16 Children's Care Centers and more than 400 outreach clinics. A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Additional Information Department: Revenue Integrity Hours per week: 40, eligible for benefits Shift: M-F, 8-5 Job Overview Responsible for analyzing revenue performance, identifying revenue leakage and incorrect charges. Evaluates revenue trends to identify root causes. Designs and implements correction plans to improve charging efficiency. Works closely with hospital clinical managers and directors to globally review charge generation workflows to prevent revenue leakage and improve charging workflows. Assists with CCI, MUE, and Epic Revenue Guardian checks and edits. Runs charge reconciliation reports and supports clinical areas in effectively monitoring their revenue. Collaborates closely with the Revenue Integrity Charge Auditors to assist with follow-ups and actions plans from internal department charging audits and external payor audits. Assists Revenue Integrity CDM Analyst with CDM maintenance as it relates to improving charging efficiencies. #LI-TS Responsibilities Population Specific Care - No direct patient care. Essential Functions An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform. - Identifies and analyzes a variety of data sets including industry trends and develops actionable insights and business strategies. - Completes moderate to complex detailed data collection and analysis. - Creates, reviews, analyzes, and maintains accurate reports. Ensures the integrity and quality of data and reports. - Creates and manages a wide variety of reporting tools. - Creates business intelligence tools or systems to analyze and report key metrics. - Develops and maintains training and training resources for end users. - Assists in completion of needs analysis for department/unit. - Communicates and disseminates information regarding tools, report, analysis, and data enhancements. - Serves as the systems liaison with vendors, IT and other internal and external system managers/partners. - Develops, Implements, maintains, troubleshoots and provides technical expertise on relevant databases and/or systems. Other Information COMPETENCIES - BUILDING CUSTOMER LOYALTY - Meeting and exceeding internal or external customer expectations while cultivating relationships that secure commitment and trust. - BUILDING PARTNERSHIPS - Developing and leveraging relationships within and across work groups to achieve results. - COMMUNICATION - Conveying information and ideas clearly and concisely to individuals or groups in an engaging manner that helps them understand and retain the message; listening actively to others. - CONTINUOUS LEARNING - Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application. - DECISION MAKING - Identifying and understanding problems and opportunities by gathering, analyzing, and interpreting quantitative and qualitative information; choosing the best course of action by establishing clear decision criteria, generating and evaluating alternatives, and making timely decisions; taking action that is consistent with available facts and constraints and optimizes probable consequences. - EMOTIONAL INTELLIGENCE - Establishing and sustaining trusting relationships by accurately perceiving and interpreting own and others' emotions and behavior; leveraging insights to effectively manage own responses so that one's behavior matches one's values and delivers intended results. - INNOVATION - Creating novel solutions with measurable value for existing and potential customers (internal or external); experimenting with new ways to solve work problems and seize opportunities that result in unique and differentiated solutions. - MANAGING RELATIONSHIPS - Meeting the personal needs of individuals to build trust, encourage two-way communication, and strengthen relationships - PLANNING AND ORGANIZATION - Establishing an action plan for self and others to complete work efficiently and on time by setting priorities, establishing timelines, and leveraging resources. - QUALITY ORIENTATION - Accomplishing tasks by considering all areas involved, no matter how detailed; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time. - RESOLVING CONFLICT - Helping others deal effectively with an antagonistic situation to minimize damage to the relationships and promote shared goals; using appropriate interpersonal methods to reduce tension or conflict between two or more people and facilitate agreement. - STRESS TOLERANCE - Maintaining stable performance under pressure or opposition (e.g., experiencing time pressure, conflict, or job ambiguity); handling stress in a manner that is acceptable to others and to the organization. - Extensive experience with software such as Excel, Word, Access and PowerPoint. - Ability to analyze problems and apply quantitative and qualitative analytical approaches. - Ability to interpret complicated information and develop next steps designed to reach an conclusion independently and make recommendations on decisions or appropriate next course (s) of action. SCOPE AND LEVEL Guidelines: Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions. Complexity: Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices. Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or are without precedent are taken up with the supervisor. Communications: Contacts with the public or employees where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function. Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review. Qualifications - EDUCATION - Bachelor's degree in Computer Science, Education, Management Information Systems or a related field. - EXPERIENCE - Three years of previous experience in data analytics and/or operational analysis. - Coding experience preferred - Ability to prioritize tasks and communicate effectively - Proven ability to extract and analyze charging data. Knowledge of revenue codes, CPT, HCPC coding - Proficient in Microsoft Excel - Knowledge of compliance regulations and billing requirements - EQUIVALENCY - Professional experience, beyond requirements, in a related field may substitute for a Bachelor degree requirement on a year for year basis. Physical Requirements Ability to Perform Essential Functions of the Job - Audio-Visual: Hearing: Good - Audio-Visual: Near Vision: Good - General Activity: Sit: 2-4 hrs. per day - Weight Lifted/Force Exerted: Up to 10 pounds: 1/3 or more of time Work Environment - Mental and Emotional Requirements: Independent discretion/decision making. - Mental and Emotional Requirements: Makes decisions under pressure. - Mental and Emotional Requirements: Manages stress appropriately. - Mental and Emotional Requirements: Works with others effectively. Equal Employment Opportunity It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

Keywords: Children---s Hospital Colorado, Aurora , Revenue Integrity Analyst, Professions , Aurora, Colorado

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