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Radiology Revenue Integrity Analyst - Radiology Administration

Virginia Commonwealth University Health Systems
United States, Virginia, Richmond
Mar 17, 2025
The Revenue Integrity Analyst plays an important role in a team tasked with improving revenue results. Reviews clinical and financial processes, functions and interdependencies from patient care to final bill generation. This position advises and coordinates implementation of revenue capture workflows, policies, protocols, training, education and systems which support the enhancement of revenue for ancillary departments and service lines. Ancillary departments include Radiology, Cardiology, Pathology and Pharmacy.

The Revenue Integrity Analyst evaluates the department's revenue capture and billing processes to ensure compliance with applicable laws, regulations and policies. The position coordinates revenue capture processes for new services.

The Revenue Integrity Analyst facilitates audits with a focus on revenue cycle integrity. Due to its service focus and project management emphasis, this position requires the ability to work with autonomy, strong interpersonal and communication skills, and well-developed analytic and organizational skills. Licensure, Certification, or Registration Requirements for Hire:
Certified Procedural Coder (CPC) or
Certified Outpatient Coding (COC), formerly CPC-H by the American Academy of Professional Coders, or
Certified Coding Specialist Physician-based (CCS-P), or
Certified Coding Specialist (CCS), or
Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA)
Licensure, Certification, or Registration Requirements for continued employment:
Certified Procedural Coder (CPC) or Certified
Outpatient Coding (COC), formerly CPC-H by the American Academy of Professional Coders, or
Certified Coding Specialist Physician-based (CCS-P), or
Certified Coding Specialist (CCS), or
Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA)
Must be obtained within one(1) year from employment
Experience REQUIRED:
Minimum of one (1) year hospital related experience in auditing
Three (3) years recent patient and/or professional billing or charge services or reimbursement practices and procedures experience in an Integrated Health System
Previous training/education in project management or project coordination
Previous experience at the intermediate to advanced level with windows based software applications (Microsoft Word, Excel, PowerPoint, and Outlook). Previous analytical experience
Experience PREFERRED
Minimum of four (4) years of patient billing and reimbursement practices and procedures in an acute care hospital and/or physician office
Minimum of three (3) years of progressive coding and/or coding review experience
Four (4) years medical and/or professional billing or charge services experience
Previous experience with regulatory requirements relative to reimbursement and clinical documentation
Education/training REQUIRED:
Associates Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field or in lieu of degree, four (4) additional years of relevant work experience may be considered.
Education/training PREFERRED:
Bachelor's Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field
Independent action(s) required:
Must have advanced revenue code, CPT and HCPCS coding knowledge.
Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations.
Solid understanding of multiple reimbursement systems including IPPS, OPPS, and Fee Schedule.
Working knowledge of multiple clinical and financial healthcare applications, such as Cerner, IDX and CDM maintenance software.
Provide guidance and education on correct charge capture, coding and billing processes to multiple clinical departments and practices.
Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff.
Ability to audit and document clinical and revenue integrity workflows to enhance maximum charge capture and reduce late fees.
Possess effective oral and written skills, including formal presentation skills.
Excellent organizational, research, and project management skills. Strong analytical skills with the ability to work with large data.
Possess effective time management skills to permit handling of large workload.
Supervisory responsibilities (if applicable): N/A
Additional position requirements: N/A
Age Specific groups served: Adult
Physical Requirements (includes use of assistance devices as appropriate):
Physical Lifting less than 20 lbs.
Activities: Prolonged sitting, Walking (distance), Repetitive motion
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.

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