Revenue Integrity Analyst

Revenue Management

Full Time

69614BR

Job Summary

The Revenue Integrity (RI) Analyst serves as the subject matter expert for ambulatory coding and charges integrity services requiring intervention and resolution in optimizing the middle revenue cycle.   The RI Analyst will provide coding and charge capture services for all UCSF Health entities where deficiencies have been identified.  The incumbent will conduct root cause analysis, and provide recommendations for process improvements, system optimization, and required documentation to ensure proper reimbursement for services is rendered. The RI Analyst will utilize all government and 3rd party payer information to ensure policies and procedures are applied. The incumbent engages both clinical and revenue cycle departments with comprehensive education and training for optimal application, workflow understanding, and claims processing. This position has a broad understanding of all areas of the revenue cycle including Patient Financial Services (PFS), SBO (Single Billing Office), Patient Access, Health Information Management (HIM), Compliance, and Government Reimbursement, and a sound understanding of Hospital and Professional components in an Epic environment.

Department Description

The Revenue Management Department takes a multidisciplinary approach in the revenue cycle to aid in properly capturing charges and ensures accurate billing for clinical services rendered to patients across the enterprise. The department incorporates compliance and privacy practices, leverages automation and technology, and applies effective processes and internal controls that continually result in root cause correction and process improvements.

Required Qualifications

• Bachelor’s degree in a related area and/or equivalent experience /training.
• Three or more years of experience in clinical charge capture, charge description master, coding, government/third-party reimbursement, or similar healthcare experience
• Thorough knowledge of the practices, procedures, and concepts of the healthcare revenue cycle, specifically revenue integrity, and its component operations, including billing, coding, collections, charge capture, contractual adjustments, third-party reimbursements, and compliance. 
• Experience in managing and/or developing charge description master or charge capture processes, policies, and/or procedures. 
• Knowledgeable in the use and application of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and Revenue codes. 
• Thorough understanding of the issues, processes, reporting instruments, metrics, analytics, and other tools and techniques involved with measuring and analyzing the revenue cycle. 
• Detail-oriented, with a proven ability to effectively manage time, see tasks and projects through to completion, organize competing priorities, and effectively address complex, urgent issues as they arise. 
• Strong skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in a common database, spreadsheet, and presentation software. 
• Strong communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations. 
• Strong analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems and propose innovative solutions.  
• Strong interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment with staff from a wide variety of business and clinical areas.
• Proven ability to work with managers, serving as a technical resource, providing recommendations and advice on complex regulatory changes, and industry trends and developments in revenue cycle management. 
• Practical experience using hospital information systems, Epic billing system preferred, and computer proficiency with PC applications (e.g. Microsoft Office). 

Preferred Qualifications

Master’s degree in a related area and/or equivalent experience/training

License/Certification

Licenses: 
Clinical License (Nurse, Technician, etc) – Preferred
Certifications:
Coding certification (e.g. RHIA, CCS, etc.) – Required
Epic certification – Preferred

About UCSF

At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what’s possible for the patients we serve – a promise we share with the professionals who make up our team.

Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report – UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence – also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Job Code and Payroll Title

007589 REVENUE CYCLE HC ANL 3

Job Category

Financial, Professional (Non-Clinical)

Bargaining Unit

99 – Policy-Covered (No Bargaining Unit)

Location

Remote / Telecommute

Additional Shift Details

M-F