The Revenue Integrity Analyst maximizes charge efficiency through (a) monitoring revenue cycle processes and staff functions; (b) supporting GoHealth revenue capture integrity by evaluating the accuracy of charge capture and billing functions and staying apprised of payor and/or regulatory updates; (c) assisting in the design and implementation of charge capture/billing workflow improvements.

Additional Knowledge, Skills and Abilities Required

• Strong knowledge of Excel, Word, and PowerPoint
• Ability to interact with and work with peers and management
• Ability to make judgements in demanding situations
• Ability to react to frequent changes in duties and volume of work
• Effective communication skills
• Ability to logically organize details
• Epic and/or ECW experience

ESSENTIAL FUNCTIONS

• Leads the development and refinement of charge capture workflows.
• Leads the development, fine tuning, and auditing of charge capture reconciliation.
• Develops and maintains dashboards and reports on charge capture and charge capture reconciliation.
• Monitors, reports, and takes action on trends in claim denials and zero payments.
• Recommends front end staff education and communication for denial prevention.
• Develops and maintains dashboard and reports on denial and zero payment management and prevention.
• Prepares summaries that pinpoint root causes of charge and billing errors.
• Participates in Charge Master (CDM) and Physician fee schedule maintenance efforts
• Additional miscellaneous duties and responsibilities, as may be assigned.