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Munson Medical Center Sr Revenue Cycle Analyst in Traverse City, Michigan

JOB SUMMARY

As a member of the Revenue Integrity Team, this position will work with revenue producing departments to maintain and update the system-wide Charge Masters. Responsible for pricing logic analysis, departmental reviews, compliance to governmental regulations and third-party billing support. Position will involve problem-solving, routinely interacting with the CBO and facility claim processing personnel.

ENTRY REQUIREMENTS Bachelor’s degree in healthcare or business related field is required. RHIA certification is preferred. RHIA certification must be obtained within 3-5 years of hiring.

Registered Nurse with the State of Michigan is preferred.

Meditech and/or Cerner hospital information system experience is preferred.

Seven or more years of experience in healthcare or healthcare finance.

Solid understanding of medical records coding, competence in regulatory issues with knowledge and experience of hospital charging and billing is essential.

Strong communication skills, both written and verbal, are required to interact effectively with all levels of hospital personnel.

Previous experience in chargemaster development, hospital billing procedures and working with a variety of third-party payor issues is required.

Must be computer proficient and adaptable to new software systems. Good working knowledge or MS Office programs including Word and Excel.

Previous experience in facilitating educational sessions or in staff training is required.

Experience in coordinating or conducting record documentation, coding and/or charge auditing is preferred.

Significant contact and interaction with customers in many departments.

Ability to work independently, establish priorities, meet tight deadlines and handle diverse
responsibilities.

Ability to function in a complex multi-company environment. Actively participate in setting and attaining departmental goals.

ORGANIZATION Reports to Sys Dir Revenue Integrity.

SPECIFIC DUTIES

  1. Supports the Mission, Vision and Values of Munson Healthcare

  2. Embraces and supports the Performance Improvement philosophy of Munson Healthcare with a focus on True North.

  3. Promotes personal and patient safety.

  4. Uses effective customer service/interpersonal skills at all times.

  5. Responsible for the updating and routine maintenance of the Hospitals’ chargemasters.

  6. Oversight for routine benchmarking studies for competitive pricing.

  7. Routinely monitor the chargemaster to ensure accurate coding, consistency in billing and compliance to all Federal, State, and Local regulations.

  8. Conduct periodic chargemaster audits and serve to educate patient service departments on the billing/charging process.

  9. Keep current with all regulations and requirements for all payors, identify changes, and facilitate resolution as necessary.

  10. Work to identify lost opportunities for reimbursement and implement corrective actions were indicated.

  11. Work closely with the revenue cycle team to resolve issues related to CPT/HCPC codes, revenue codes, annual updates for additions, deletions, changes, etc.

  12. Participate/coordinate the annual clinical department CDM review.

  13. Work with Internal Audit to implement their audit findings.

  14. Monitor and measure effectiveness of revenue cycle changes implemented.

  15. Review monthly revenue cycle reports to identify and disclose trends.

  16. Be a resource for questions regarding new services, medical necessity criteria, various payor edits such as 3M and NCCI edits, and for unique billing problems.

  17. Performs other duties and responsibilities as assigned.

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