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Kootenai Health

Revenue Integrity Analyst

Career Insights for Business Analyst (General)

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What they do

A Business Analyst provides strategic management consulting to companies and businesses. Advises on ways to improve operations, increase efficiency, reduce costs and increase revenues; may recommend systems or organizational change. May specialize in an area of business practice or a specific industry; may also specialize in consulting with government agencies.

$97,046 / year median in Idaho

-23% projected decline

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Job Description

Revenue Integrity Analyst Job Code:
29237 Position Summary The Revenue Integrity Analyst is responsible for charge reconciliation and analysis of financial data as it relates to regulatory compliant charging and billing guidelines. Under general supervision, this position supports the entire revenue cycle by using clinical expertise and analytical skills to resolve charging and billing issues. Responsibilities
  • Maintains confidentiality of all information related to patients, medical staff, employees, and as appropriate, other information
  • Responsible to maintain a working knowledge of the culture and different practices/services as a Multi-Facility department and organization
  • Uses clinical, audit and analytical skills to independently conduct reviews of medical record documentation compared to patient charges on a concurrent and/or retrospective basis
  • Works closely with charge producing departments and IS and takes initiative in investigating and resolving billing and charging issues
  • Provides education to clinical departments on charge entry, accuracy, reconciliation, and compliance
  • Independently addresses patient, department, and administrative requests for a variety of issues related to revenue and charge integrity
  • Performs analysis on suspected issues to determine root cause and provide correction action plan
  • Assists in charging audits, internal charging audit, denials, and external charging audits
  • Supports Revenue Integrity team members; responds positively to special projects and responsibilities, including performance objectives
  • Performs other related duties as assigned
  • Relies on experience and judgment to plan and accomplish goals
  • Regular and predictable attendance is an essential job function
  • Competent to meet age specific needs of the unit assigned Requirements and Minimum Qualifications
  • Bachelor's degree preferred
  • Coding certification, Certified Healthcare Financial Professional (CHFP) or Certified Revenue Cycle Representative (CRCR) preferred
  • Minimum 3 years' experience in the healthcare industry (such as business office, finance, revenue auditing, coding, etc.) required
  • Extensive familiarity with CPT and HCPCs charge codes
  • Knowledge of the dynamics of charge accuracy programs
  • Strong computer skills including working knowledge of Excel and Word. Ability to adapt quickly to new systems and tools.
  • Strong knowledge of hospital and clinic billing requirements, billing systems, payer contract parameters, proration protocols
  • Demonstrated experience with process improvement strategies and the development of effective workflows Working Conditions
  • Must be able to lift and move up to 10 lbs
  • Must be able to communicate and exchange accurate information
  • Must be able to maintain a sitting position
  • Typical equipment used in an office job
  • Remote eligible
About Kootenai Health:
Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider. As your next employer, we are excited to offer you: Comprehensive medical coverage, including fully employer‑paid options for eligible full‑time employees, plus affordable plans for part‑time staff. Benefits begin on the 1st of the month following 30 days of employment. Dental, vision, life, and pet insurance, with telemedicine and wellbeing resources available to all employees Tuition assistance after 90 days to support your professional growth Retirement plans with pre‑tax and Roth options and employer matching from 3%-6% Competitive pay, plus night, weekend, and PRN shift differentials Award‑winning wellness program with coaching, financial wellness resources, and free or discounted access to fitness centers and premium wellbeing apps PerkSpot discounts providing access to thousands of exclusive deals in over 25 categories And an employee referral bonus program Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.