Job Details

The Billing Integrity Analyst will provide professional skills necessary for insuring compliance relating to Medicare billing requirements for both facility and professional billing processes, audit related processes for compliance, work with IT to ensure all appropriate build and edits are in place and communicate and update staff on changes as they relate to the new and/or updated billing requirements. Provides input to Revenue Cycle Director(s) on policies and procedures to enforce compliance regulations and CMS guidelines, decision making and problem-solving activities related to compliance programs. Responsible for review/research of all Medicare and/or Payers new requirements, updates and/or changes that effect billing to determine the items that require action. Billing Integrity Analyst is responsible for researching complex payor claim edits including but not limited CCI, MUE, MAU as well as complex payer denials and working closely with our Denials Manager on recommendations ...Billing, Analyst, Integrity, Compliance, Healthcare, Business Services, Revenue