GoHealth Urgent Care

USA

Posted on: 17 April 2024

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Revenue Integrity Analyst

JOB SUMMARY

The Revenue Integrity Analyst maximizes charge efficiency through (a) monitoring revenue cycle processes and staff functions; (b) supporting GoHealth revenue capture integrity by evaluating the accuracy of charge capture and billing functions and staying apprised of payor and/or regulatory updates; (c) assisting in the design and implementation of charge capture/billing workflow improvements.

JOB REQUIREMENTS

Education

High School Diploma or GED required
Bachelor’s Degree preferred

Work Experience

Minimum three years’ of CBO experience working in various CBO departments
Five years of progressive experience communicating through various means across all job categories

Required Licenses/Certifications

Epic Physician Billing Certification, preferred
CPC or CCSP

Additional Knowledge, Skills and Abilities Required

Strong knowledge of Excel, Word, and PowerPoint
Ability to interact with and work with peers and management
Ability to make judgements in demanding situations
Ability to react to frequent changes in duties and volume of work
Effective communication skills
Ability to logically organize details
Epic and/or ECW experience

ESSENTIAL FUNCTIONS

• Leads the development and refinement of charge capture workflows.
• Leads the development, fine tuning, and auditing of charge capture reconciliation.
• Develops and maintains dashboards and reports on charge capture and charge capture reconciliation.
• Monitors, reports, and takes action on trends in claim denials and zero payments.
• Recommends front end staff education and communication for denial prevention.
• Develops and maintains dashboard and reports on denial and zero payment management and prevention.
• Prepares summaries that pinpoint root causes of charge and billing errors.
• Participates in Charge Master (CDM) and Physician fee schedule maintenance efforts
• Additional miscellaneous duties and responsibilities, as may be assigned.