Revenue analyst ii

Primary City/State: Virtual - Arizona

Category: Billing and Revenue Cycle

Shift: Day

Department: Revenue Compliance

Must reside in the state of Arizona.

Great care starts with great people. (Like you.) At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area.

Responsibilities:

JOB SUMMARY The Revenue Analyst II is responsible for the development, implementation, maintenance and audit functions of a standard system-focused hospital Charge Description Master (CDM). The position will deliver, monitor and maintain a consistent accurate CDM that is compliant with regulatory guidelines; conduct pricing updates and work closely with team members to prepare and submit the annual rate filing with the State of Arizona in accordance with State guidelines; provide advice and support to facility staff as needed; and maintain the CDM to ensure accurate charge capture and will work with relevant departmental staff to ensure Charge Master information is properly routed to any and all systems dependent upon charge data. The position works in a cooperative team environment to provide value to internal and external customers. The position will work closely with the Revenue Services team to conduct departmental process improvement projects for the benefit of charge capture and revenue integrity.

Aspects of the role will require extensive data mining and abstracting of financial and clinical information from various decision support tools for, but not limited to, charge master support, revenue and reimbursement analyses, and ad hoc reporting needs of department.

ESSENTIAL FUNCTIONS

• Acts as Team Leader and/or Project Manager for special projects related to CDM and reimbursement data.
• Serves as liaison between Revenue Services and support areas, Department Managers and special task forces/committees representing CDM and charge capture issues.
• Serves as internal coordinator for projects performed by consultants and external parties for CDM issues.
• Coordinates internal audits related to charge capture departmental issues, defense audits and or patient complaint audits.
• Uses appropriate analytic applications and decision support tools in conjunction with Excel and Access, to abstract information for financial analysis and decision support purposes in the area of reimbursement, including forecasting/trend analysis, cost analyses, financial projections, and other duties as may be identified to assist department and System decision making.
• Familiarity with CDM auditing & maintenance tools (i.e. Craneware)
• Analyzes patient billing system requirements, and Charge Master Application validation and maintenance with respect to the CDM.
• Research and resolve revenue and billing issues and develop corrective action plans when necessary.
• Assists and works with PFS, Information Systems, Decision Support, Department Managers and others in the design and modifications of system, reports and conversion requirements.
• Monitor compliance initiatives related to CDM data.
• Track OIG, FBI, Attorneys General, Fiscal Intermediary/Carrier and other regulatory agencies compliance investigatory activities and published findings that may be correlated to CDM data billed.
• Serve as a team member and resource for compliance information on regulations applicable to healthcare providers.
• Interact with leadership, department managers and facility staff members regarding CDM compliance and related CDM financial issues.
• Develops, implements, maintains and performs audit functions to the standard system focused charge description master (CDM).
• Responsible for making CDM related decisions that require significant analysis and investigation with solutions requiring significant original thinking.
• Responsible for using broad discretion to define and execute CDM related activities with freedom to proceed on major assignments.
• Assist as a team member in the development, implementation and improvement of internal controls needed to assure and maintain sound billing practices.

EDUCATION Bachelors or 4 years' work related experience in business or healthcare field Required

EXPERIENCE 2 years related experience Required 5 years to 7 years of progressive responsibility in CDM Maintenance and revenue analysis. Preferred

Other Current knowledge of the Revenue Flow in healthcare financial systems. Comprehensive experience with inpatient and outpatient billing requirements of UB-04 and CMS 1500 billing forms. Preferred

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