University of Illinois
Chicago, IL, United States
Finance, Planning, Accounting
Mar 25, 2020
Jul 08, 2020
UI Health is seeking a Finanical Analyst Planner Specialist (Revenue Integrity Analyst) to join the Patient Accounting - Revenue Integrity team.
The Revenue Integrity Analyst is responsible for department charge capture processes and controls under the direction of the Revenue Integrity Manager. This position acts as the liaison between Patient Accounting and other revenue generating departments to ensure charging practices follow Federal and State billing regulations, while simultaneously ensuring appropriate, optimal reimbursement. This position is responsible for improving charge capture accuracy through workflow assessments, coordinating coding reviews, process improvements, and generating reports. The Revenue Integrity Analyst works collaboratively with leadership to assist in the development and implementation of process enhancements or initiatives that enhance charge capture accuracy and reimbursement. This position oversees, understands, and communicates departmental charging processes, including the electronic health record charge links to the CDM and charging processes. This position also works closely with Information Services to complete and test charge-related build by having a clear understanding of the charging workflows and triggers built within the electronic health record.
Charge Description Master (CDM):
Develops and maintains procedures and educational materials for department management regarding the following:
o CDM update and maintenance procedures for billing codes and pricing
o Procedures for CDM “new item” requests
o Department specific changes to charging/billing regulations affecting the CDM
o Ongoing education and updating of charge reconciliation procedures
Monitors Medicare charge requirements and maintains knowledge of all third-party payer guidelines, as well as federal and state regulations.
Acts as a liaison between system leaders and CDM for regulatory updates, changes, deletions and new procedure additions
Identifies any charge issues including, but not limited to, procedure descriptions, coding compliance, charge amounts, multiplier set up and reimbursement method updates
Performs technical review to ensure accuracy, validity, appropriateness, and completeness of CDM
Process management functions may include data gathering, analysis, and determination of the charge, charge attributes (when and how a charge is triggered, charge routing, etc.), and charging workflow for new services and products
Resolves charge updates or concerns, working with Information Systems, Utilization Management, Health Information Management, Patient Access and Patient Accounting to keep cohesive and compliant charge practices
Maintain current knowledge of ICD-10 and CPT coding regulations
Sets up, modifies, deletes and adds all charge master item requests as it relates to the Epic charging workflows
Assists with additional CDM projects such as tiered pricing and material management updates
Works with Pharmacy, Lab and Materials Management in charge master set-up, cost, units, etc. Meet with departments to review their area of charge master at the minimum yearly and ideally twice a year
Daily review and resolution of Epic workqueues (e.g. charge router, charge review, account, claim, etc) owned and/or monitored by Revenue Integrity to ensure that edits are resolved accurately and in a timely manner to support generation of a claim with all relevant charges posted when billing is initiated
Analyzes daily revenue capture by monitoring and trending gross revenue using various tools (e.g. Charging Dashboard Components, Revenue and Usage Reports, Enterprise Charge Encounter Reports, etc)
Monitors and supports for clinical operational department leaders in working of charge review work queues. Provision of training and support for resolution of charge and charging related claim edits
Provision of initial training and ongoing education for clinical operational department managers, cost center owners and/or charge reconciliation specialist
Investigates departments where there are decreases inpatient volumes and/or posted revenue amounts compared to baselines, discovers root causes, and reports out to revenue cycle and clinical department leadership
Maintains working knowledge of CPT and HCPCS charging as well as all billing edits, CCI, OCE, MUE’s, and other relevant billing guidelines
Provides recommendations based upon findings to improve charge capture workflows and to standardize charge capture practices
Reports on trends, findings, and opportunities for improvement to management detailing findings and high-risk items that leaders should be monitoring, including missing, incorrect, and late charges
Evaluates, researches, and analyzes revenue and billing to ensure compliance with all payer requirements and determine patterns of charging that will increase the propensity for payment of charged services
Supports clinical departments in implementing solutions that support more efficient and effective work performance based on inherent knowledge of business processes which include coordinating and leading workgroup meetings to help identify solutions to charge issues
Performs department charge audits, assists departmental leaders with effective charge reconciliation processes, educates clinical departments on workflows causing billing edit resolutions, tracks problematic claim trends, and communicates/escalates issues along with recommended resolution pathways
Works closely with individual facility representatives/clinical staff to establish and maintain positive relations to ensure revenue integrity goals are achieved
Participates in onsite meetings and interact on a regular basis with site-based department leaders regarding changes in charge capture practices
Ensures that the department charge master charging workflow needs for all departments are being met
Works with the Patient Accounting leadership team when applicable to ensure that payer contracts/fee schedules are being paid as negotiated
Works with the Patient Accounting leadership team when applicable to ensure that federal and state payers are being paid per fee schedule/payment methodology
Ensures that payer regulatory changes are communicated
Ensures timely response to department questions and charge master requests
Development of Skills
Maintains knowledge of all third-party payer regulations including state and federal both for billing and charging
Maintains knowledge of all compliance regulations
Maintains knowledge of all payer charging rules and regulations including Federal, State and Commercial
Develops and maintains an excellent knowledge of Epic and MS Office products
Maintains a high level of computer, proof reading, written and verbal-communication skills
Maintains excellent interpersonal skills including the ability to communicate effectively with internal and external customers
Maintains current and updated working knowledge of all business application solutions
Maintains current knowledge of ICD-10 and CPT coding regulations
Maintains working knowledge of UI Health’s Intranet to obtain pertinent administrative information
Recommends changes to current billing practices to enhance billing productivity and revenue recovery
Recommends all changes in charging systems both federal, state and commercial
Minimum Acceptable Qualifications Required:
Any one or any combination that equals three (3) years (36 months)
from the categories below:
A. progressively more responsible experience in developing financial or economic analyses, research designs, strategic plans, or data models
B. credit for college course work comparable to that in a field related to financial analysis/planning such as finance, planning, economics, or operations research with 12 hours in empirical fields such as statistics or computer science
60 semester hours equals 1 year (12 months)
90 semester hours equals 2 years (24 months)
120 semester hours or higher equals 3 years (36 months)
Two (2) years (24 months)
of work experience comparable to that gained as a Financial Analyst/Planner Associate in addition
to the experience/training required in 1 above.
A Master's Degree in accounting, business administration, and/or finance, or other related fields, used to satisfy requirement #1 may be used in satisfying this requirement as well.
Preferred Hospital and professional reimbursement, charge capture and charge master experience
Preferred Working knowledge of CPT & HCPCS coding guidelines
Preferred Epic certifications or experience
Preferred knowledge of Excel and SQL queries
Certification as a Revenue Cycle Integrity Professional (CRIP). Certification preferred within 1 year of date of hire
Attend Epic for the training for Resolute Hospital Billing Charging certification within 6 months of date of hire. Obtain certification within 1 year of date of hire.
RHIA, RHIT, CCS, CPC/COC, CPC-H, or other coding credentials strongly preferred. Extensive understanding of correct coding principles of CPT/HCPCS and modifier selection as well as CCI edits and billing guidelines.
For fullest consideration, please complete an online application by clicking the Apply for Position
Fully complete all sections of the online application including adding your full work history with specific details of your duties and responsibilities for each position held. Please fully completed the Education and Certification sections.
Please upload all valid certifications and transcripts within the document section of your online application.
All civil service positions require an exam. The exam for this position is a Credentials Assessment. You will not be required to report in person for this exam.
Credential Assessment Exam Scoring Information
You will not
be required to report in person for this exam. The updated online application and all uploaded, relevant documents, such as a resume and/or college transcript will be used in the calculation of the exam score. These documents should be uploaded prior to the position close date.
When completing your online application, please be sure to provide detailed information about your job knowledge and specific duties and responsibilities, as your qualifications for any Civil Service position will be primarily determined based on what is contained in the application. Dates of employment and if employed on a full or part time basis (including number of hours per week) must be indicated for each position held. Additional consideration will be given to supporting documentation i.e. resume, transcripts, licenses, and certifications so please be sure to attach all applicable documents.
If a degree or college coursework is required, you must provide official transcripts.
Transcripts/Licenses/Certifications MUST be uploaded electronically to your online application through the Documents page on the Civil Service Employment Application (page 4). Be sure to select the appropriate document type before uploading the document.
If your educational institution provides electronic transcripts, please have them sent to
If your educational institution doesn’t provide electronic transcripts, they must mail the transcripts to: email@example.com
University of Illinois at Chicago
Recruitment and Staffing
Human Resources Building Room 109
715 S. Wood Street M/C 862
Chicago IL 60612
Attn: Financial Analyst Planner Specialist - HR
If an application and all applicable forms, transcripts, and supporting documents are not submitted by the close date, the applicant/employee will not be considered for this position and will be denied.
For fullest consideration, the above mentioned requirements must be submitted no later than Tuesday 4/10/2020
We appreciate your interest in employment at the University of Illinois at Chicago.
The University of Illinois is an Affirmative Action/Equal Opportunity Employer.
This position requires Illinois residency within 180 days of the hire date.
University of Illinois
Website : http://www.uic.edu