Revenue Integrity Analyst

We’re looking for a Revenue Integrity Analyst, someone who’s ready to grow with our company. In this position you will lead, manage, and/or participate in all Revenue Integrity related projects as assigned by the Director. This incumbent is also responsible for leading and/or supervising initiatives to improve or optimize efficiency while serving both internal and external customers.

Think you’ve got what it takes?

Job Duties & Responsibilities

• Edit and exception resolution. Resolves or coordinates the resolution of charge session edits including DNB, revenue guardian edits, denials, and audits on a timely basis.
• Apply coding, payer and charge capture conventions to compliantly resolve edits
• Identifies opportunities for capturing additional revenue in accordance with payer guidelines
• Keeps edits and exceptions within targets as assigned by leadership
• Coordinates efforts for resolution with all Revenue Cycle Departments as appropriate
• Communicates with clinical departments, when needed, to assist in edit resolution
• Evaluates edits to determine potential opportunities for automated resolution
• Maintains high productivity and quality with minimal supervision over assigned work queues
• Develops measures to track, trend, and monitor charge sessions and account resolutions, including audits and denials.
• Provides consistent and clear feedback to the Revenue Integrity Team, Revenue Cycle Counterparts, and Hospital Operations and Providers
• Track and trend defense audits
• Identify and monitor departments with charge capture and denial issues and develop processes for improvement.
• Serve as the contact and advocate to assigned Service Line leadership for all revenue cycle processes and workflows.

Skills & Requirements

• Required High School Diploma or GED HSD must be accompanied by a certification or bachelor's degree  
• Required one of the following certifications:
  • CHRI - Certified Healthcare Revenue Integrity Professional by the National Association of Healthcare Revenue Integrity (NAHRI)  
  • CRCR - Certified Revenue Cycle Representative by the Healthcare Financial Management Association (HFMA)  
  • CHFP - Certified Healthcare Financial Professional by the Healthcare Financial Management Association (HFMA)  
  • CSAF - Certified Specialist Accounting & Finance by the Healthcare Financial Management Association (HFMA)  
  • CPC - Cert-Cert Professional Coder by the American Academy of Professional Coders (AAPC)  
  • RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)  
  • RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)  
  • CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)  
  • CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)  
  • COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)  
• Required 4 years Revenue Cycle experience, including but not limited to Revenue Integrity, Billing, Coding, Denials, Follow-Up, Patient Accounts, and/or Refunds experience

**Hospital Billing and Coding Background highly desired

About Texas Children’s

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. 

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children’s Health Plan, the nation’s first HMO focused on children; Texas Children’s Pediatrics, the largest pediatric primary care network in the country; Texas Children’s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. 

 To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

 Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.