Analyst, Revenue Integrity

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

The Revenue Integrity Analyst reflects the mission, vision, and values of Northwestern Medicine, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Revenue Integrity Analyst will work directly with the Revenue Integrity Senior Analyst to support the Clinical Department and revenue cycle and perform charge capture analysis including annual price increase analysis. The Revenue Integrity Analyst will be responsible for helping maintain the charge master to ensure compliance, accuracy, and consistency for Northwestern Medicine.

Responsibilities:

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Identify charge capture opportunities or compliance issues in revenue producing departments.
• Research billing and coding regulations. Communicate and assist in implement any necessary changes to impacted area that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Assist in quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy. Take necessary action to ensure accurate charging on patient accounts.
• Support complex audits and prepares methodology for annual pricing review and coding changes.
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Consistently delivers concrete, relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving. In addition to results orientation, displays business knowledge, speed and decisiveness, and project management.
• Supports the finance, operations and revenue cycle teams through special projects.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, adopting and implementing industry best practices, and participating in professional societies.
• Protect operations by keeping financial and patient information confidential.
• Support the finance operations of Northwestern Medicine.

    Revenue Integrity Analyst – Project Management and Data Analytics Responsibilities

• Work collaboratively with project executive sponsor and project teams to ensure goals are achieved
• Recognize risks, issues, and problems that arise within projects and recommend mitigation/remediation strategies to achieve desired results
• Apply strong facilitation skills to project meetings
• Assist with the development of detailed plans to monitor and validate the achievement of project goals including timeline and event milestones, key operational and strategic performance indicators, and other appropriate metrics
• Assist with the development of project files and documentation including but not limited to work plans, status reports, issue logs, and resource plans
• Meet financial objectives by identifying and evaluating trends; analyzing variances; initiating any corrective actions or adjustments.
• Prepare reconciliations; analyze variances; and initiate corrective actions on transactions with a high degree of complexity in support for finance and operating departments.
• Provide support and analysis by querying appropriate data, preparing reports, making presentations of analysis, findings, and recommendations to management.
• Increase productivity by developing automated processes, eliminating duplication, coordinating information requirements.

Required:

• Bachelors Degree in Business or related field or 10+ years of equivalent experience with progressive advancement.
• 3+ years of relevant experience
• Excellent communication, collaboration, analytical, and accounting skills
• High level of precision and attention to detail
• Expert knowledge of Microsoft Office Suite
• Moderate / Advanced understanding of CPT coding and third party billing requirements
• Knowledge and experience with Medicare/Medicaid regulations

Preferred:

• Healthcare finance experience
• EPIC Certification (Resolute Charge Capture)
• RHIA preferred or related health care credential (e.g. Radiology technician, RN)

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.