Senior Revenue Integrity Analyst

Are you passionate about ensuring financial integrity and compliance within a healthcare organization? Do you have a strong background in revenue analysis and a thorough understanding of reimbursement methodologies? If so, we have an exciting opportunity for you to join our team as a Senior Revenue Integrity Analyst at Highmark Health.In this role, you will play a crucial part in optimizing revenue and minimizing compliance risks by conducting audits, analyzing trends, and implementing process improvements. You will also serve as a subject matter expert for revenue cycle operations and collaborate with cross-functional teams to drive revenue integrity initiatives.To excel in this position, you must have a Bachelor's degree in Healthcare Administration, Finance, or a related field, along with a minimum of 5 years of experience in revenue cycle management, coding, or auditing. Strong analytical skills, attention to detail, and the ability to communicate complex information effectively are also essential for success in this role.If you are a self-motivated, results-driven professional with a passion for revenue integrity, we encourage you to apply for this challenging and rewarding position at Highmark Health. Join us in our mission to provide accessible, affordable, and high-quality healthcare to our community.

1. Conduct audits and analyze data to identify potential revenue integrity issues within the organization.
2. Collaborate with cross-functional teams to develop and implement process improvements to optimize revenue and minimize compliance risks.
3. Serve as a subject matter expert for revenue cycle operations, reimbursement methodologies, and compliance regulations.
4. Monitor and analyze trends in revenue data to identify areas of improvement and potential risks.
5. Communicate findings and recommendations to leadership and other stakeholders in a clear and concise manner.
6. Stay up-to-date with industry trends and changes in regulations related to revenue integrity and compliance.
7. Conduct regular training and education for staff on revenue cycle processes and compliance requirements.
8. Develop and maintain strong relationships with internal and external stakeholders to ensure effective revenue integrity management.
9. Ensure all revenue integrity processes and procedures are in compliance with regulatory standards.
10. Provide support for external audits and work with regulatory agencies to resolve any compliance issues.
11. Mentor and train junior revenue integrity analysts to ensure a high level of performance and adherence to best practices.
12. Collaborate with IT teams to develop and maintain revenue integrity systems and tools.
13. Conduct regular assessments and audits to ensure proper coding and billing practices are being followed.
14. Monitor and report on key performance indicators to measure the effectiveness of revenue integrity initiatives.
15. Act as a liaison between revenue cycle operations and other departments to identify and resolve revenue integrity issues.
16. Adhere to all confidentiality and data security policies and procedures.
17. Act as a role model for ethical and compliant behavior within the organization.
18. Maintain a high level of accuracy and attention to detail in all revenue integrity activities.
19. Continuously seek opportunities to improve revenue integrity processes and procedures.
20. Stay current on all relevant laws, regulations, and industry best practices related to revenue integrity and compliance.

According to JobzMall, the average salary range for a Senior Revenue Integrity Analyst in Pittsburgh, PA, USA is $80,000 - $110,000 per year. Salaries may vary depending on factors such as the size and type of organization, years of experience, and specific job responsibilities.

Highmark Inc. is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.