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Revenue Cycle Project Analyst- Revenue Integrity

ChicagoR1 RCM

Set your sights on a role making a real difference in the healthcare system. We’re looking for a self-motivated Revenue Cycle Project Analyst to join our team. We have a relentless focus on driving results for our customers and enabling them to invest more into patient care; in turn, this allows us to continue to grow our company and your career.

The Revenue Cycle Project Analyst will be responsible for reviewing revenue and pricing opportunities to increase reimbursement. This person will be working with product owners and customer owners to present findings and partner on key projects. This person will be leveraging Excel and custom database to perform data analysis and conduct ongoing reviews with the product team and hospital partners.  The Project Analyst will also provide research, analysis and recommendations regarding the organization's compliance with regulatory requirements affecting patient billing and accounting practices.

In this role, the successful candidate will have strong analytical skills with a professional, driven attitude. The National Revenue Integrity Team works collaboratively in a large team atmosphere.  

Your day to day role will include:

  • Researches charging and billing questions for new and existing services to ensure appropriate revenue recognition
  • Conducts regular bill audits to identify areas of missed revenue and makes recommendations based on audit results
  • Gathers and compiles data in a systematic fashion and prepares Excel analysis leveraging Vlookups and pivot tables
  • Prepares analysis using benchmark data obtained through internal and external databases to analyze and forecast budget impact in order to facilitate changes
  • Conducts analysis and prepares budget information for clinical department meetings reflecting volumes, gross and net revenue, costs per the cost accounting module, and purchases/expenses
  • Maintains current knowledge of regulations and statutes regarding patient billing and accounting practices
  • Researches questions related to the organization's compliance and provides recommendations
  • Coordinates Medicare and other regulatory reviews/audits
  • Monitors key compliance measures and develops corrective action plans based on analysis
  • Ensures all claims are submitted in accordance with CCI guidelines by assisting Medicare billers with research, correction and processing of any claim not passing CCI edits

You Have:

  • A Bachelor’s degree is required
  • Advanced Excel skills including Vlookips and pivot tables
  • Ability to learn quickly in a fast paced environment
  • Desire to work within healthcare field
  • Basic understanding of healthcare revenue cycle
  • Strong communication skills and ability to work in a team environment
  • Performance improvement focused and highly detail oriented

It would be great if you also have:

  • Master’s degree
  • Understands healthcare revenue cycle code sets: CPT, HCPC, ICD-9, Service Location, Revenue Code
  • Has basic understanding of contract reimbursement  

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