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Revenue Integrity Analyst

Remote

Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry.  Wilshire will take the time to get know you and your employment history.  We will then place you in a role that will lead to a path of career success.  

About The Wilshire Group

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

Why Wilshire? Employee Testimonial

“The number of RCM subject matter experts I get to work with each day is unreal.  Working alongside and as part of this team to help shape the RCM space is exciting.”-Patti Consolver, Director of Business Development 

 
This position offers 65% of fee sharing.  Fee sharing is based on the client and project.  The fee-sharing bill rate can be anywhere from $80.00-100.00 per hour for this project.
 
Job Overview
   
The Revenue Integrity analyst position is responsible for maintaining the integrity of our charge capture and reconciliation for pertinent clinical areas. This position will be expected to perform audits of current charge capture practices, correct charging errors, and analyze trends and issues within clinical departments. This role will work within the Revenue Integrity department.  Will work closely with PFS (e.g. billing office), Finance, Compliance, and relevant clinical areas on a day-to-day basis with the ultimate goal of ensuring accurate and compliant charge capture. | 

Responsibilities:
An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the tasks which the employee may be expected to perform. Perform department charge capture and reconciliation audits identify charge capture opportunities provide support on charge capture improvement projects maintains knowledge of inpatient and outpatient billing requirements, coding guidelines, CMS Medicare reimbursement methodologies, and chargemaster components (HCPCS, Rev Codes, etc) Completes moderate to complex detailed data collection and analysis. Creates, reviews analyzes and maintains accurate reports. Ensures the integrity and quality of data and reports. Creates and manages a wide variety of reporting tools. Develops and maintains training and training resources for end users. Assists in the completion of needs analysis for department/unit. Communicates and disseminates information regarding tools, reports, analysis, and data enhancements. | 
  
Qualifications

EDUCATION – - Bachelor’s degree in Business, Health Care Administration, Finance or a related field. Applicable experience may be accepted in lieu of a degree. Coding certification is preferred but not required.
EXPERIENCE –  Three years of previous experience in coding or revenue integrity with in Epic Access/Revenue Systems (Grand Central, Cadence, HIM, Prelude, Resolute (ARHB)
EQUIVALENCY – Professional experience, beyond requirements, in a related field may substitute for a Bachelor's degree requirement on a year-for-year basis. 
 
Physical Requirements

Ability to Perform Essential Functions of the Job
Audio-Visual: Hearing: Good Audio-Visual: Near Vision: Good
General Activity: Sit: 2-4 hrs. per day weight Lifted/Force Exerted: Up to 10 pounds: 1/3 or more of time
Work Environment Mental and Emotional Requirements: Independent discretion/decision making. Mental and Emotional Requirements: Makes decisions under pressure. Mental and Emotional Requirements: Manages stress appropriately.
Mental and Emotional Requirements: Works with others effectively. |  

Wilshire is honored that you have taken the time to review/apply to our open position.  We will now take the time to review your experience and be in touch with you soon.

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