Senior Revenue Integrity Analyst
Northeast Georgia Health System
United StatesPosted 18 days agoDiscoveredMatch locked
RemoteFull Time
Job Category
Revenue Cycle
Work Shift/Schedule
8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.
Job Summary
The Sr. Revenue Integrity Analyst provides subject matter expertise in charge capture, CDM application, compliance, and reimbursement. The Sr. Revenue Integrity Analyst leads audits, supports governance, and drives revenue optimization initiatives across clinical departments while ensuring alignment with CMS and payer requirements.
Minimum Job Qualifications
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Licensure or other certifications
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Educational Requirements
Bachelors Degree
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Minimum Experience
5+ years hospital revenue cycle, charge capture, or CDM
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Other
A combination of relevant certification(s) and demonstrated work experience may substitute for the required degree.
Preferred Job Qualifications
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Preferred Licensure or other certifications
CPC, CCS, RHIT/RHIA, Epic Certification.
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Preferred Educational Requirements
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Preferred Experience
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Job Specific and Unique Knowledge, Skills and Abilities
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Advanced knowledge of CPT/HCPCS and reimbursement
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Expertise in CDM structure and clinical application
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Strong auditing and compliance background
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Ability to analyze financial impact of charge issues
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Experience with workflow redesign and optimization
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Advanced Excel and data analysis skills
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Ability to lead training and education initiatives
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Strong communication across clinical and executive teams
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Knowledge of CMS, Medicaid, and payor rules
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Essential Tasks and Responsibilities
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Monitor departmental charge capture accuracy to ensure thorough analysis of work queues and reconciliation reports.
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Identify charge capture gaps, workflow issues, and systemic revenue loss risks.
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Provide guidance, training, and education to clinical departments
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Partner with CDM team on updates and recommend improvements
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Conduct pre/post bill audits to validate charge mappings and billing rules.
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Analyze trends and root causes impacting reimbursement, compliance, and financial performance.
- Quantify revenue at risk and assess the financial impact of charge and develop corrective action plans to optimize revenue initiatives.
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Ensure CMS and regulatory compliance
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Support CPT/HCPCS annual updates
- Collaborate cross-functionally with Coding, IT, Finanace, Compliance and leadership to resolve issues and improve processes.
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Support governance committees
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Develop reports and dashboards and deliverdata-driven recommendations to leadership.
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Physical Demands
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Weight Lifted
Up to 20 lbs, Occasionally 0-30% of time
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Weight Carried
Up to 20 lbs, Occasionally 0-30% of time
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Vision
Moderate, Frequently 31-65% of time
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Kneeling/Stooping/Bending
Occasionally 0-30%
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Standing/Walking
Occasionally 0-30%
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Pushing/Pulling
Occasionally 0-30%
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Intensity of Work
Frequently 31-65%
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Job Requires
Reading, Writing, Reasoning, Talking, Keyboarding, Driving
Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.
NGHS: Opportunities start here.
Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
Originally posted on Himalayas
Not included in the source posting: benefits.
Skills
excel
Who can apply
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