Revenue Integrity Analyst at GoHealth Urgent Care

JOB SUMMARY   

   

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.   

   

JOB REQUIREMENTS   

   

  

• 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.