Job Description

Position Summary:

The Revenue Analyst reflects the mission, vision, and values of Northwestern Memorial, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

Under the general supervision of the Clinical Coding /Finance Manager, the Revenue Analyst resolves several edit/error reports associated with coding and billing processes as well as identifies error patterns and recommends solutions to reduce billing errors.

Responsibilities:

• Monitor and resolve bill hold edits for failed medical necessity (LCD), NCCI (National Correct Coding Initiative) and Charge/Edits.
• Identify and communicate coding or billing edit/error patterns to facilitate improved front-end processes.
• Review and validate the appropriateness of the patient ABN (Advanced Beneficiary Notice).
• Review clinical documentation to apply appropriate, complete, and consistent ICD-9-CM or CPT-4 codes for reimbursement, administrative uses, quality/patient safety measurement and research.
• Advance coding knowledge and practice through continuing education and utilize all available reference resources in 3M and MedAssets.
• Investigate and resolve coding/billing issues as identified by Patient Accounting, Denials & Appeals, Billing Inquiry Unit and Registration.
• Provide ICD-9-CM & CPT coding expertise to ancillary departments and physician offices via the coding Help Line.
• Ensure timely and accurate processing of billing.

Additional Functions

• Understand APC reimbursement methodology
• On-going maintenance of AHIMA/AAPC credentials
• Education of HIT/HIM students that are completing their affiliations with NMH.
• Understand Medicare/Medicaid regulatory guidelines in reference to LCD coverage.

Qualifications

Required

• RHIA/RHIT, CCS, CPC or CPC-H

Preferred

• Degree in Health Information Technology or Health Information Management

Additional Information

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.