REVENUE INTEGRITY ANALYST (100% Remote M-F)

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

General Description of the Job Class

REVENUE INTEGRITY ANALYST (100% Remote M-F)

Perform detailed analyses and audits of patient accounts to ensure revenue integrity in relation to adherence to federal and state regulations.  Through an account review, identify trends in system and operational behavior. Determine opportunities for improved system or operational performance.  Summarize and communicate account review findings with precision to influence and motivate positive change. Exercise independent decision-making using analytical and problem-solving skills. 

Duties and Responsibilities of this Level

• Account analysis is aimed at determining if documentation, charge capture, payment, or adjustments are appropriately posted.
• Follow up with appropriate health team members to ensure accurate and complete documentation within the medical record.
•  Develop trends and deter necessary mitigation activities.
• Communicate and partner with PRMO Re venue managers.
• Develop impactful reporting to assist with the demonstration of revenue cycle outcomes.
• Work collaboratively with operational leaders to develop service line education strategies to promote complete and accurate clinical  documentation.
• Complete quality control audits and report audit results or corrective action on plans.
• Oversee audit corrective action plans and contribute to the construction of workflow enhancements to avoid future audit findings.
• Serve as a subject matter expert to leadership on issues related to revenue integrity.
• Monitor and manage Charge Integrity WQs, ensuring qualified inventory is timely reviewed and released.
• Other duties as assigned

Required Qualifications at this Level

Education: A bachelor's degree in business administration, accounting, management, health care administration, nursing or another related degree.

Experience: 3 years of experience related to auditing and/or coding is required.  Clinical experience is preferred.

Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or another related degree.

3 years of experience related to auditing and/or coding is required. Clinical experience is preferred

Coding certification (e.g., CCS, RHIA, RHIT) or applicable experience is preferred.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.