Revenue Integrity Analyst - CarePoint Health

About Us:

CarePoint Health is one of New Jersey’s leading health care systems comprised of three long-standing and highly-regarded hospitals – Bayonne Medical Center, Christ Hospital, and Hoboken University Medical Center. CarePoint united these three area hospitals to provide 360 degree coordinated care by integrating the medical facilities and physician networks associated with these institutions. With over 3,500 employees, CarePoint is the largest private employer in Hudson County, New Jersey, and each year provides care to over 300,000 individuals.

 

CarePoint prides itself on its patient-focused approach to care delivery, with an emphasis on preventative medicine, health education, and disease management. Leveraging its vast network of physicians and healthcare experts, CarePoint is quickly becoming recognized as a leader in the broader healthcare landscape as it pioneers creative solutions to address urgent population health needs.

What You'll Be Doing:

The Revenue Integrity Analyst is responsible for financial, statistical, and operational projects.

 

          The successful candidate will be able to:

 

• Present detailed analysis of A/R performance and other financial reports and related outcomes/trends; researches and validates clinical data used to support medical necessity of billed services, conducts quality assurance reviews of various billing components, technical requirements, supporting processes, systems and required documentation; reviews outcomes with wide array of people (i.e., Practice/clinical Directors, Practice/clinical Managers, senior leadership, Coding Manager, hospital case management,
• Assist with maintaining the integrity of the CDM (charge description master) and the software program.
• Work with Revenue Cycle regulatory
• Facilitates meetings both internal and external; works collaboratively with system compliance leadership to coordinate and manage payer audit appeals.
• Serves as the Revenue Cycle regulatory liaison between the Practice and the department for efficient management of accounts receivable, point of service Revenue Cycle activity and all other areas within the Revenue Cycle area.
• Serves as an internal audit consultant to clinical providers.
• Identifies barriers and implements corrective action measures in partnership with leaders to ensure positive outcomes.
• Provides ongoing guidance, training and support to practices and departmental Revenue Cycle staff.
• Works collaboratively with physicians, leadership, and health professionals to accomplish organization and Revenue Cycle and practice goals.
• Responsible for monitoring and auditing of Revenue Cycle issues; monitor facility departments,
• Identify under- and over-opportunities to improve Revenue Cycle compliance; identify under- and over-charge items for immediate resolution by the provider/practice; identify areas for risk as well as improvement - conducts assessments both desk level and on site.
• Provides ongoing education to departments, practices management system, coding and regulatory complexities (i.e., billing and A/R management workflows, policies and requirements); develops and implements action and educational plans to target resolution of Revenue Cycle issues; identify training needs as well as appropriate hand-off for designated topics.
• Collaborates with Compliance, Patient Accounts, Health Information Services, Internal Audit and other Revenue and Finance departments on revenue management initiatives.
• Develops and maintains a Quality Audit program and associated reporting.
• Assists in performance of quality audits related to RI liaison and charge review coordinators identified areas of opportunity.
• Other duties as assigned.

What We're Looking For:

• Bachelor’s degree required in Healthcare Administration, Business Administration or similar; Master’s degree preferred
• eCW, Meditech, word, PowerPoint, Excel

What We Offer:

• Competitive pay
• Medical, dental, and vision insurance
• 401k with Company match
• Generous paid time off
• Paid Holidays
• Tuition Reimbursement
• Advancement and career development opportunities

Covid-19 and Influenza Vaccinations are a requirement for employment at CarePoint Health. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from CarePoint.

 

CarePoint Health is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status, or any other characteristic protected by law.

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