Sr. Revenue Integrity Analyst

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

This role functions as the senior subjectmatter expert for hospital supply and pharmacy Charge Description Master (CDM) oversight, ensuring precise charge capture and compliant billing across inpatient and outpatient settings. Expertise in separately billable supplies and implantable devices, pharmacy Medicare units of measure, NDC package size conversions, NDC validation, and Quantity Calculation Factors (QCF) is highly valued and essential to maintaining accurate reimbursement and regulatory compliance. In addition to pharmacy and supply, this position will also support and collaborate with additional clinical and operational service lines as needed.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Reviews compliance regulations and coding requirements (primarily Medicare) and incorporates these changes into the Chargemaster.
2. Autonomously educates Department Managers on compliance and coding regulations.
3. Independently coordinates with Department Managers on new procedures being performed to assure the charges are set up appropriately and timely in the Chargemaster and the staff responsible for entering charges are educated.
4. Coordinates the set-up of Chargemasters for new Departments.
5. Assists in the development of Hospital System Policies relating to charge entry, price setting, and developing new charge item.
6. Conducts audits to ensure all documented charges are captured appropriately and timely and performs audits to review the charges are being coded correctly.
7. Coordinates with the business office to resolve any denial issues related to the Chargemaster.
8. Provides guidance, support and mentoring to Revenue Integrity Analysts and Coding Analysts.
9. Monitors revenue by trending, troubleshooting and analyzing data such as charge lag, late charges, denials and/or wRVU volumes.
10. Collaborate with other Northside departments and leadership as it relates to the revenue cycle and betterment of Northside.
11. Assists Revenue Integrity Coordinator in other projects and analyses.

REQUIRED

1. B.S. degree in Nursing, Health Information Management, Healthcare Administration or Business Administration; or Associates Degree with 8 years of hospital charge master experience in lieu of a bachelor's degree.
2. Must have a coding or nursing credential (RHIA, RHIT, CCS, RN) or a financial background.
3. Must have minimum of 5 years hospital Charge master experience.
4. Demonstrated communication skills and an ability to work independently and deal effectively with various types of personnel.
5. Knowledge of Microsoft Office products.
6. Self-Motivated leader with a collaborative mindset, driven to take initiative and build the department's reputation of quality service.

PREFERRED

1. Three to five years Chargemaster experience in a hospital setting.