INTEGRIS Health

Analyst

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines and Epic workflows
• Develop advanced dashboards and predictive analytics models for denial trends, charge lag, missed charges, and net revenue opportunities
• Perform cost-benefit analyses for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support payment policy or denial escalations
• Collaborate with Compliance, Legal, and CDM teams on governance structures, billing corrections, and regulatory requirements
• Serve as senior analyst for multiple high-volume or high-risk service lines
• Lead quarterly and ad-hoc reviews with operational executives
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

Revenue Integrity Analyst III

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks; develop corrective-action recommendations
• Design and oversee charge capture improvement projects across multiple service lines and Epic workflows
• Develop dashboards and predictive analytics models monitoring denial trends, charge lag, missed charges, and net revenue opportunities
• Perform cost-benefit analyses for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support escalations of payment policy or denial issues
• Collaborate with Compliance, Legal, and CDM teams on governance, billing corrections, and regulatory requirements
• Serve as senior analyst for high-volume or high-risk service lines
• Lead reviews with operational executives and present findings and recommendations
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

• Ensure accurate revenue capture, payer compliance, and optimized reimbursement for the health system
• Investigate and analyze high-impact billing edits, recurring revenue discrepancies, and coding/documentation risks
• Identify trends, root causes, and corrective actions
• Lead in-depth charge capture reviews and implement improvements in documentation, charging practices, and revenue accuracy
• Develop, analyze, and present dashboards and reports on denial trends, charge lag, missed charges, net revenue performance, and other revenue metrics
• Perform cost-benefit analyses for revenue improvement proposals, workflow redesigns, and operational strategies
• Participate in payer and internal audits; prepare documentation, support responses, and assist with corrective action planning
• Partner with Compliance and CDM teams to monitor risks, implement billing corrections, and support enterprise-wide initiatives
• Serve as the designated analyst for assigned high-volume or complex clinical service lines
• Lead quarterly reviews with operational leaders, presenting findings, trends, risks, and improvement opportunities
• Collaborate with clinical, operational, and compliance stakeholders to strengthen documentation and charge capture processes, reduce denials, and improve net revenue realization

Revenue Integrity Analyst II

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines
• Develop advanced dashboards and predictive analytics models for denial trends, charge lag, missed charges, and net revenue opportunities
• Perform complex cost-benefit analyses and financial modeling
• Lead payer and internal audits and support payment policy or denial escalations
• Collaborate with Compliance, Legal, and CDM teams on governance, billing corrections, and regulatory requirements
• Serve as senior analyst for multiple high-volume or high-risk service lines
• Lead quarterly and ad-hoc reviews with operational executives
• Mentor Analysts I and II and provide technical guidance, coaching, and quality assurance

Certified Coder

• Analyze clinical and demographic information from health records to assign ICD-10-CM and CPT/HCPCS codes
• Review and analyze medical records for outpatient diagnosis and procedure coding
• Apply coding guidelines in accordance with regulatory and organizational standards
• Identify documentation gaps and initiate queries for clarification
• Resolve routine coding edits and initiate inquiries for accurate code assignment
• Maintain productivity and accuracy standards while managing assigned work queues
• Work cooperatively with coding team members and internal partners
• Communicate documentation needs and coding questions to stakeholders
• Use coding tools and references to resolve routine issues and escalate when needed
• Complete assigned coding work accurately and within established timelines
• Follow workflows and identify basic efficiency opportunities
• Support accurate coding outcomes contributing to reimbursement and data integrity
• Adapt to changes in coding guidelines, tools, and payer requirements

General

• Perform routine scheduling and registration activities, including handling incoming scheduling calls and scheduling patients
• Verify patient demographic information and process point-of-service payments
• Provide general preparation instructions and perform document imaging according to documentation standards
• Perform patient access transactions, including coverage eligibility, insurance verification, patient portion calculation, and authorization requirements
• Manage heavy phone volume and work under time pressure while interacting with patients and health system departments and caregivers
• Resolve routine patient issues and assist with reimbursement questions
• Make outbound and accept inbound calls from patients, physician offices, and insurance carriers
• Collect patient payments and follow levels of authority to ensure financial clearance
• Communicate effectively by telephone, email, and verbally
• Participate in process improvement and continuous quality improvement initiatives
• Establish goals with supervisors and track progress
• Comply with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts

Scheduling Specialist

Patient Access Specialist

• Ensure appropriate complex patient access transactions, including coverage eligibility, insurance verification, patient portion calculation, and authorization requirements
• Perform financial counseling, screen for government programs and financial assistance, explain payment options, process point-of-service payments, verify demographics, obtain signatures, and complete document imaging
• Adjust service area schedules and accommodate special requests from internal and external customers
• Accept inbound calls from patients, physician offices, and insurance carriers and resolve concerns
• Collect patient payments and follow authority levels to ensure financial clearance
• Document patient account activities, authorization requirements, and patient liability requirements
• Respond to inquiries about pre-care services, policies, coverage, benefits, and financial liability
• Use multiple resources to resolve patient or payer inquiries and prepare or review patient accounts and prior authorization requirements
• Explain payer regulations, coverage benefits, and financial liability to patients
• Maintain compliance with performance standards, EMTALA, HIPAA, regulations, policies, procedures, guidelines, and third-party contracts
• Follow safety rules, report accidents, and correct minor safety hazards

Manager

• Complete comprehensive assessments of patients’ clinical, psychological, and financial needs
• Recommend and coordinate timely transfers to appropriate levels of care
• Develop, implement, evaluate, and revise discharge plans, including referrals
• Communicate discharge care plans and changes to patients, families, and healthcare professionals
• Assist physicians and hospital staff with resource utilization and timely discharge planning
• Coordinate services between hospital departments to facilitate patient discharge
• Conduct concurrent reviews of patient records
• Apply utilization criteria to determine appropriate resource utilization
• Notify internal and external contacts about utilization issues affecting patient care or reimbursement
• Facilitate patient transfers according to hospital policies and applicable regulations
• Advise physicians on discharge planning, documentation, resource utilization, and reimbursement
• Manage established pathways to enhance clinical effectiveness and resource management
• Maintain knowledge of CMS, Medicare, Medicaid, managed care, payer regulations, and benefit limits
• Educate patients, families, and healthcare professionals about payer regulations and benefits
• Develop knowledge of hospital and community resources and facilitate appropriate levels of care
• Identify opportunities to reduce care-management costs without affecting quality or outcomes
• Collect and record data for utilization and Quality Improvement reporting
• Collaborate with patients, families, physicians, hospital staff, and other care organizations

RN Case Manager – Utilization Review

• Call patients and schedule visits in coordination with the established plan of care, supervising clinician, and scheduling department
• Perform patient care according to the care plan and patient tolerance
• Provide a patient report to the supervising clinician after each visit
• Maintain a clean and safe patient environment, including changing bed linens, cleaning the immediate area and bathroom, and light housekeeping
• Prepare progress notes and complete paperwork documenting patient care in the medical record
• Report to the Team Manager or Clinical Manager
• Follow standard precautions when exposed to infections, communicable diseases, blood and body fluids, electrical equipment, and chemicals

Home Health Aide – PRN

Nurse

• Assess and reassess patients
• Develop patient care plans
• Implement appropriate patient care interventions
• Evaluate patient care interventions
• Supervise and coordinate licensed and non-licensed personnel in providing assigned patient care
• Provide guidance and mentorship to non-licensed personnel and students as appropriate
• Manage delivery and documentation of patient care
• Report to the appropriate manager, director, or vice president
• Follow standard precautions

Revenue Integrity Analyst III

Revenue Integrity Analyst III

Revenue Integrity Analyst II

Revenue Integrity Analyst III

Certified Coder

Scheduling Specialist

Patient Access Specialist

RN Case Manager – Utilization Review

Home Health Aide – PRN

Registered Nurse – Hospice