Revenue Chrg Intgrty Analyst

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Job Summary

The Charge Integrity Analyst plays an essential role in Michigan Medicine's Revenue Cycle. Analysts maintain charge and charge-related functionality, provide system and departmental support, and help to ensure the integrity and accuracy of patient accounts.

 

The core functionality of Charge Integrity is to maintain the hospital and professional charge master and fee schedules. Analysts are expected to remain current on regulatory updates in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee. Analysts work with a large variety of Revenue Cycle and non-Revenue Cycle teams to support charge capture functionality and ensure proper charging practices. Daily tasks include monitoring and working work queues, analyzing charts, addressing charging/process issues and investigating system errors. Projects are assigned to ensure proper build, testing, training, and monitoring of system upgrades and optimizations. Analysts are expected to work closely and promote an atmosphere of teamwork with other members of Charge Integrity as well as their peers in Revenue Cycle, to achieve department objectives and provide stellar customer service.

 

This position requires strong analytical skills. Analysts must demonstrate the ability to pull and analyze data and documentation, determine root causes, and recommend solutions based on standard coding and billing best practices. Strong excel skills are essential. Knowledge of clinical and hospital workflows, compliance, MiChart, and Epic certifications are beneficial. Analysts must be organized, detail oriented, and work well independently. 

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities*

  • Ensure that the Charge Master is built and maintained in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee standards. Stay current with CMS and other regulatory and payor mandated charge capture guidelines, including revenue code, CPT, HCPCS, and modifier changes. 
  • Maintain Coding Certification including staying current on articles, newsletters, memos and attend seminars to successfully oversee the Charge Master and ensure its proper use. 
  • Learn, utilize, and maintain Charge Master data in FinThrive and in the Epic EAP master file. 
  • Set hospital rates following department policy, using standardized pricing algorithms, available benchmarking and other rate setting tools. 
  • Work with other Charge Integrity team members and MiChart CORE team as assigned to maintain the following MiChart Files: 
    • HB and PB Chargeable, Orderable and Performable (EAP) 
    • Hourly and Daily Bed Charge Billing Table (BCB) 
    • Cost Center Assignment Table (CCAT) and Cost Center Table (BCC) 
    • MiChart Rules (Router, Claims Manager, Revenue Guardian, etc.) 
    • Fee Schedules 
  • Maintain and support Charge Capture Preference Lists, Bedside Procedure Smartforms, Clinic Performed Orders/Procedures, LOS, Smartsets and other charge capture tools built within the Epic system. 
  • Learn departmental systems and workflows that interface/support charge capture. 
  • Maintain files of all critical correspondence, tracking all charge and fee schedule changes. 
  • Participate in the design, build, and testing of new MiChart and WQ rules that track and identify potential charge errors. 
  • Assist in developing and establishing new departments (including the build of their charges and charge capture and revenue routing and reconciliation tools). 
  • Work with Clinical Departments, Revenue Cycle peers, and other MiChart teams to ensure proper charge generation from clinical systems. Provide support as needed to Finance and other Revenue Cycle departments. 
  • Monitor and work MiChart Workqueues on a timely basis. Communicate to other departments who may need to assist with corrections. Identify areas of improvement. 
  • Act as liaison between Billing and Clinical Departments to investigate and resolve issues. 
  • Participate in design, build, test script development, testing, training and go-live support of periodic MiChart Upgrades, new module implementations, system optimizations and other organizational projects.
  • Run reports, analyze, and distribute as necessary. 
  • Patient estimate work as assigned. 
  • Other projects and ad hoc reports as assigned. 

Required Qualifications*

  • Associate's degree in Business Administration, Health Administration, Health Information Management, Health Information Technology, Nursing or equivalent combination of education and work experience. 
  • Experience with facility reimbursement, coding process and compliance concerns related to a charge master. 
  • Experience as a Certified Coder, Charge Master Administrator, Revenue Integrity Specialist, Epic Analyst or Senior Biller with government payers or equivalent combination of experience. 
  • Demonstrated problem solving, analytical and organizational skills. 
  • Demonstrated ability to research root cause and recommend solutions. 
  • Extensive experience with Electronic Health Record clinical and billing workflows (such as Epic or Cerner). 
  • Extensive experience with MS Office tools with strong emphasis on advanced Excel knowledge. 
  • Self-starter and detail oriented with the ability to work well independently. 
  • Excellent communication with the ability to articulate both written and verbal communication(s). 
  • Strong customer service focus. 
  • Great attendance record. 

Desired Qualifications*

  • Bachelor degree in Business, Health Administration, Nursing or equivalent combination of education and experience. 
  • RHIT, Coding certification or equivalent combination of education and experience. 
  • Experience with University systems including, Epic EHR (MiChart), Toad DataPoint/Hyperion IR, DataMart, Outlook, payer websites. 
  • Proficiency in Microsoft PowerPoint, Access, Visio. 
  • Hospital Billing experience within the last 5 years of this posting. 
  • Knowledge of University Health System policies, procedures and regulations. 
  • Knowledge of or experience in the delivery of patient care and front-end workflows. 
  • Experience performing financial and billing data reviews; claim and medical record reviews; analyzing documentation, identifying areas of financial risk and potential. 
  • Experience interpreting and applying CMS and other third-party payer guidelines and regulations.

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled any time after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.