Senior Revenue Integrity Analyst

🕒 July 25

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Northeast Georgia Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Northeast Georgia Health System is a healthcare organization dedicated to improving the health of the community it serves. With a presence that includes 5 hospitals, 6 urgent care locations, and more than 110 doctor's offices, imaging centers, cancer treatment centers, and laboratories, the system offers a comprehensive range of medical services. It provides career opportunities in various areas, including nursing, allied health, and support services, as well as residencies and fellowships for healthcare professionals. The organization is committed to its mission through adherence to core values, offering employee benefits, and engaging in community activities. With locations providing access to both metropolitan and natural amenities, it emphasizes quality of life for employees and residents in Northeast Georgia.

📋 Description

• Provide subject matter expertise in charge capture, CDM application, compliance, and reimbursement • Lead audits, support governance, and drive revenue optimization initiatives across clinical departments • Monitor departmental charge capture accuracy through work queue analysis and reconciliation reports • Identify charge capture gaps, workflow issues, and systemic revenue loss risks • Provide guidance, training, and education to clinical departments • Partner with the CDM team on updates and recommend improvements • Conduct pre- and post-bill audits to validate charge mappings and billing rules • Analyze trends and root causes affecting reimbursement, compliance, and financial performance • Quantify revenue at risk and assess the financial impact of charge issues • Develop corrective action plans to optimize revenue initiatives • Ensure CMS and regulatory compliance • Support annual CPT/HCPCS updates • Collaborate with Coding, IT, Finance, Compliance, and leadership to resolve issues and improve processes • Support governance committees • Develop reports and dashboards and deliver data-driven recommendations to leadership • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree required • 5+ years of hospital revenue cycle, charge capture, or CDM experience • Relevant certifications and demonstrated work experience may substitute for the required degree • Advanced knowledge of CPT/HCPCS and reimbursement • Expertise in CDM structure and clinical application • Strong auditing and compliance background • Ability to analyze the financial impact of charge issues • Experience with workflow redesign and optimization • Advanced Excel and data analysis skills • Ability to lead training and education initiatives • Strong communication across clinical and executive teams • Knowledge of CMS, Medicaid, and payer rules • Experience with dashboards and reporting • Ability to read, write, reason, talk, keyboard, and drive • Preferred certifications: CPC, CCS, RHIT/RHIA, or Epic Certification

🏖️ Benefits

• Full-time employment • Monday–Friday daytime schedule • Opportunities for professional development and career growth • Training and education initiatives • Equal opportunity employment