[Hiring] Revenue Integrity Analyst @Duke University

Role Description

This position serves a critical function within Duke Health’s Charge Description Master (CDM) team by supporting revenue integrity and charge capture optimization initiatives. Responsibilities include:

• Reviewing pre-bill accounts flagged through Epic Revenue Guardian edits.
• Entering missing hospital (HB) charges based on supporting medical documentation.
• Leveraging critical-thinking and analytical skills to evaluate charge capture opportunities.
• Determining appropriate charge corrections.
• Developing strategies for implementing new Revenue Guardian edits to reduce revenue leakage.
• Exercising independent judgment and problem-solving abilities while providing analytical support related to third-party payer reimbursement and contract compliance.

Duties and Responsibilities of this Level

• Conducting quality control audits to ensure data/documentation integrity, and trending of accounts that qualify for Revenue Guardian edits. (20%)
• Serving as Subject Matter Expert to leadership on issues related to Revenue Integrity. (10%)
• Preparing monthly reports and educational presentations for clinical departments and Revenue Manager teams. (20%)
• Following up with appropriate health team members to ensure accurate and complete documentation in the medical record. (20%)
• Reviewing charges and payments for accuracy from contracted payers and managing the appeals process. (20%)
• Performing other related duties incidental to the work described herein. (10%)

Qualifications

• Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related degree.
• 3 years of experience related to coding is required.
• Charge capture, reporting, and analysis experience is preferred.
• Coding certification (e.g. CPC, CCS, RHIA, RHIT) is required.
• In-depth knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements.
• Revenue Cycle experience.
• Strong oral and written communication skills.
• Research-oriented with ability to critically analyze and reason large amounts of data.

Company Description