Shriners Children's is looking for a Revenue Integrity Analyst to ensure all items and services charged through the Charge Description Master (CDM) are described, coded, and priced appropriately. You will educate ancillary and clinical staff on required changes and collaborate to implement updates for regulatory and payor compliance.

What You'll Do

Conduct charge capture assessment activities including interviews, research, and outcomes analysis.
Provide analysis, well-supported documentation, and recommendations for changes to the CDM.
Maintain continuous communication with revenue departments and inform management of operational opportunities.
Collaborate with department managers and staff to review documentation and develop process improvement programs.
Present identified problems and solutions related to charge capture and reconciliation at staff meetings.
Support the new service addition request process.
Assist in defining and assuring compliance with standardized charge capture workflows.
Assist with monitoring the system-wide CDM to ensure coding is within applicable guidelines.
Perform technical reviews to ensure the CDM's accuracy, validity, appropriateness, and completeness.
Research CDM and patient charge issues and inquiries.
Document and implement a periodic review schedule for the CDM.
Document all changes and/or revisions to the CDM.
Participate in implementation and audit processes to ensure uniform charge application.
Perform audits with a focus on revenue cycle integrity and assist in developing charge practices.
Work with leadership to develop ongoing education programs on charge capture processes.
Assist in developing and executing educational programs, training literature, in-services, and workshops.
Serve as the primary operational point of contact for Revenue Integrity with other departments.
Develop and maintain a current database of industry-wide data for benchmarking.
Assess the accuracy of charging vehicles and work with IS to determine required software updates.
Test all implemented changes through bill generation to confirm accuracy and compliance.
Assist in identifying, defining, and functioning within proprietary software processes.
Review and/or develop reports and audit tools to support revenue integrity and outcomes measurement.
Compile statistical data, construct reports, and trend information related to charges.
Effectively and professionally communicate results, challenges, and solutions.
Develop and deliver organized reporting and communications to management and other departments.
Assist the department by covering for absences and training activities.
Participate in departmental projects and offer input for continuous improvement.
Prioritize and manage multiple tasks simultaneously in a dynamic work environment.
Perform other work-related duties as assigned.

What We're Looking For

1-3 years of experience performing CDM-related activities.
Experience with CPT-based coding principles from both inpatient and outpatient reimbursement perspectives.
Experience with UB-04, MA claim form, HCFA-1500, charge development processes, and the interrelationship of cost accounting, cost management, and compliance issues.
Associate's Degree in business, accounting, finance, or healthcare business administration—a combination of education and experience considered in lieu of a degree.
Epic EMR experience required.

Nice to Have

Applicable clinical or professional certification and licenses.
Experience working with Craneware.

Technical Stack

Epic EMR
Craneware

Team & Environment

You will report directly to the Manager of Revenue Integrity Analysts.

Benefits & Compensation

Medical coverage on your first day.
403(b) and Roth 403(b) Retirement Saving Plan with matching contributions of up to 6% after one year of service.
Paid time off, life insurance, short-term and long-term disability.
Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected.
Tuition reimbursement, home & auto, hospitalization, critical illness, and pet insurance.