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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.
   

   

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