Grace Federal Solutions is looking for an experienced Revenue Integrity Analyst (RN preferred) in the Raleigh Durham area.
Perform medical and revenue audits to ensure revenue integrity as related to adherence to federal and state regulations: policies of external payers, coding rules and guidelines. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and negotiation support with respect to third party payer reimbursement contracts.
Design, plan, organize, or direct orientation programs for employees in Revenue and Documentation Integrity, specifically around NCD/LCD usage, RAC/ADR and other process and policy documentation requirements and improvements. 10%
- Assess training needs through surveys, interviews with employees, focus groups, or consultation with managers, or customer representatives 10%
- Evaluate modes of training delivery, such as in-person or virtual to optimize training effectiveness, training costs, or environmental impacts. 10%
- Monitor, evaluate, or record training activities or program effectiveness. 5%
- Obtain, organize, or develop training procedure manuals, guides, or course materials, such as handouts or visual materials. 10%
- Collaborate with the Learning Center to broadcast RAC Monitor and other pertinent webinars/training sessions 5%
Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related degree.
3 years of experience related to auditing and/or coding is required. Clinical experience is preferred
Degrees, Licensures, Certifications:
RHIA, RHIT, or CCS coding certification. Registered Nurse (RN) preferred but not required.