Revenue Integrity Analyst, Full-Time, Remote at Adventist Health

Roseville, California, United States -

Full Time

Start Date

Immediate

Expiry Date

05 Aug, 26

Salary

95519.0

Posted On

07 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Optimization, Reconciliation Processes, Revenue Cycle Management, Insurance Contract Interpretation, Government Regulations, Reimbursement Review, Audit Tracking, Metrics and Reporting, Contractual Adjustments, Payer Practice Analysis

Industry

Hospitals and Health Care

Description

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews and analyzes revenue optimization and reconciliation processes, and identifies and resolves issues while working with Revenue Cycle departments to ensure accurate and compliant revenue capture. Works on problems of moderate to diverse scope requiring some interpretation of policies and guidelines. Applies working knowledge of the techniques, principles, theories and concepts to complete routine and non-routine assignments. Job Requirements: Education and Work Experience: * Associate's/Technical Degree or equivalent combination of education/related experience: Required * Bachelor's Degree: Preferred * Three years' revenue cycle billing/collections/reimbursement experience or managed care contracting experience: Preferred Licenses/Certifications: * Certified Revenue Cycle Representative (CRCR) Certification: Preferred Essential Functions: * Independently interprets insurance contracts, government regulations and other non-contracted reimbursement methods to implement and maintain a reimbursement system which accurately calculates expected payments and contractual adjustments from all payers at one or more entities * Establishes and organizes a systematic transparent revenue integrity audit and improves processes with ongoing tracking, metrics and reporting that demonstrates progress. * Analyzes payment/contractual adjustment/other system variances and performs detailed reimbursement review to decide whether corrective action is required within the reimbursement system, other revenue cycle departments, and/or with the payer * Collaborates with Revenue Cycle departments on contract, revenue cycle and payer practice issues in order to increase revenue integrity * Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein. Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

Responsibilities

The analyst reviews and optimizes revenue reconciliation processes to ensure accurate and compliant revenue capture. They independently interpret insurance contracts and government regulations to maintain reimbursement systems and perform detailed variance reviews.