The Revenue Integrity Analyst completes and validates charges for all areas in the peri-op division including the OR, PACU, SDS, ASC, CVOR, Endoscopy and Pain Management. This position monitors and maintains the Charge Description Master (CDM) for all applicable areas and provides the appropriate information for CDM and Lawson codes. In addition, this position works with the Revenue Integrity department to optimize hospital reimbursement for services rendered.
Reviews each perioperative procedure for appropriate charges and updates charge processes as needed.
Audits records for complete implant documentation.
Verifies accurate pricing with Captis /Vizient contracts.
Requests CDM numbers for all items after Lawson numbers are established.
Works with OR Schedulers to anticipate charges that may need to be set-up.
Collaborates with OR materials management to track invoices needed for charging and to eliminate use of x-items.
Works with vendors to facilitate timely review of invoices and charges.
Collaborates with the OR Manager and Materials Manager to identify and update Lawson for anything obsolete or inactive related to the process.
Collaborates with the Clinical Value Analysis Specialist to identify changes in vendors for OR items or new items approved in order to update and maintain Lawson.
Manages and monitors expiration dates on all IOL inventory.
Monitors surgical contract for implants with invoices submitted by vendors.
Maintains resource catalog and communicates any changes to the perioperative staff.
Supports and educates perioperative nurse managers to meet patient, staff, and physician needs including process updates.
Reviews patient charts to identify any missing information and follows up to recover all billing information from perioperative departments.
Enters billing information in the approved computer system accurately and in a timely manner.
Submits DTAR reports for all perioperative units.
Responds to audits with patient information to ensure accuracy in billing.
Performs other duties as assigned.
Experience with surgical scheduling, inventory and management information systems preferred. Proficient computer skills required. Demonstrates working knowledge of medical terminology, anatomy, physiology, disease process, pharmacology, and some knowledge with coding. Excellent verbal and written communication skills.
Associate's degree required.
If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
Good Samaritan Hospital
Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area's leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children's Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.
WMCHealth is a 1,900-bed healthcare system headquartered in Valhalla, New York, with ten hospitals on eight campuses spanning 6,200 square miles of the Hudson Valley. WMCHealth employs more than 12,000 people and has nearly 3,000 attending physicians. From Level 1, Level 2 and Pediatric Trauma Centers, the region’s only acute care children’s hospital, an academic medical center, several community hospitals, dozens of specialized institutes and centers, a state of the art Telemedicine program, skilled nursing, assisted living facilities, homecare services and one of the largest mental health systems in New York State, today WMCHealth is the pre-eminent provider of integrated healthcare in the Hudson Valley.