Revenue Integrity Analyst - UMMS (Linthicum, MD)

The University of Maryland Medical System Linthicum, MD
Job ID: 61432

Area of Interest: Professionals

Location: Linthicum, MD US

Hours of Work: (M-F, 8a-430p)

Job Facility: University of Maryland Medical System

Employment Type: Full Time

Shift: DAY

What You Will Do:

Revenue Integrity Analyst - UMMS (Linthicum, MD)

General Summary

Under general supervision, this position is responsible for the maintenance and audit functions of a standard, system focused Charge Description Master (CDM) for various hospitals within the University of Maryland Medical System. Delivers, monitors and maintains a consistent accurate CDM that is compliant with regulatory agencies. Provides advice and support to clinical departments and hospital staff. Develops, analyzes, reports and assists with the interpretation of hospital specific volume data.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Under the direction of the Senior Revenue Integrity Analysts, CDM Coordinator and Department Managers, responsible for performing CDM audits with a focus on accuracy, maintaining compliance with regulatory agencies and assisting facilities with charge capture, billing and compliance issues.

2. Communicates with UMMS departments to provide analytical and technical support regarding volume variances, charge capture, CDM accuracy, regulatory policies and procedures.

3. Processes CDM additions, deletions and change requests in a timely manner while maintaining CDM compliance with local, state and federal regulatory agencies.

4. Provides decision support to clinical departments and other customers regarding pricing, CDM concepts, HSCRC methodology and select reimbursement concepts.

5. Conducts annual CDM reviews with Clinical and Administrative Department Heads. Ensures the implementation of more frequent changes to comply with changing payor requirements and HSCRC methodology and RVU task force requirements.

6. Distributes key compliance transmittals to clinical departments. Conducts annual audit on clinical department's daily charge reconciliation processes to ensure methodology is compliant with University of Maryland Medical System standards.

7. Completes necessary updates to encounter forms and facilitates changes to ancillary order entry systems to clinical departments, ITG, PFS or other appropriate individuals and monitors acknowledgment of implementation.

8. Participates in charge validation testing related to new system implementations and / or existing clinical / financial system upgrades. Responsible for maintaining detailed work papers and reporting results of charge validation testing to Department Manager.

9. Prepares and submits audit findings and makes recommendations to Department Manager.

10. Communicates with UMMS departments and front line management personnel to provide analytical and technical support regarding hospital volume changes and helps resolve issues identified. Assists the clinical department managers in understanding variances from budget and documenting new services that impact encounter forms, charge capture processes and changes to the CDM.

11. Analyzes reports to determine areas of improvement or in need of further investigation; determines appropriate plan of action and works with department to rectify any charge capture problems /questions.

12. Compiles financial and statistical reports of a specific nature in accordance with departmental procedures. Prepares weekly, monthly and annual volume reports and other routine management reports; includes analyzing revenue center detail to determine the accuracy of those reports.

What You Need to Be Successful:

Education and Experience

Bachelor's degree in Finance, Accounting or a related field is required.

Two years progressively responsible financial planning, financial analysis, budgeting, managed care or accounting experience, or the educational equivalent, is preferred.

Healthcare-related finance background is preferred.

Knowledge, Skills and Abilities

1. Minimal knowledge of Medicare and HSCRC regulations is preferred.

2. Minimal knowledge of medical terminology and use of CPT (Current Procedural Terminology) reference manuals is preferred.

4. Proficient knowledge of spreadsheets (i.e., Lotus, Microsoft Excel), databases (i.e., Microsoft Access), word processing programs (i.e., Microsoft Word), graphic/specialty and other finance-related software programs.

4. Exhibits effective verbal and written communication skills that are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.

5. Demonstrates ability to tactfully provide support to all levels of staff and management while maintaining required degree of confidentiality and purpose.

6. Ability to judge the level of confidentiality of information / activities involved in and to exhibit integrity in use of dissemination of such information.

7. Ability to develop and evaluate complex financial data via use of computer analysis.

8. Developing organization and problem-solving skills and emerging team leadership skills are required to develop and implement efficient work processes. Ability to work in a stressful environment.

9. Ability to maintain workingknowledge of the Craneware Charge Master Toolkit software, hospital specific Patient Accounting Systems, how it relates to charge master compliance objectives and their application to the various hospitals within the University of Maryland Medical System. Keeps current on Craneware system updates and enhancements.

We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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