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Clinical Resolution Analyst Jobs in Park Ridge, IL

Prolaio

Clinical Trial Lead

Chicago, IL

The Overview We are seeking a talented and motivated Clinical Trial Lead who is responsible for ... analyze data to identify opportunities and issues; demonstrated negotiation and conflict resolution ...

Prolaio

Clinical Trial Lead

Chicago, IL · On-site

The Overview We are seeking a talented and motivated Clinical Trial Lead who is responsible for ... analyze data to identify opportunities and issues; demonstrated negotiation and conflict resolution ...

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Showing results 21-40

All JobsClinical Resolution Analyst JobsClinical Resolution Analyst Jobs in Park Ridge, IL

Clinical Resolution Analyst information

See Park Ridge, IL salary details

$16

$27

$45

How much do clinical resolution analyst jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for clinical resolution analyst in Park Ridge, IL is $27.46, according to ZipRecruiter salary data. Most workers in this role earn between $22.69 and $33.61 per hour, depending on experience, location, and employer.

What is the difference between Clinical Resolution Analyst vs Medical Claims Specialist?

AspectClinical Resolution AnalystMedical Claims Specialist
Required CredentialsHealthcare-related certifications, clinical knowledgeMedical billing/coding certifications, insurance knowledge
Work EnvironmentHealthcare facilities, insurance companiesMedical offices, insurance companies, billing centers
Employer & Industry UsageHospitals, healthcare providers, insurance firmsInsurance companies, healthcare billing services
Common Search & ComparisonYesNo

The Clinical Resolution Analyst primarily focuses on resolving clinical and patient-related issues, often requiring healthcare knowledge and clinical certifications. In contrast, a Medical Claims Specialist handles billing, coding, and claims processing. While both roles work within healthcare and insurance environments, their core responsibilities differ, making this comparison relevant for those exploring healthcare support careers.

How does a clinical resolution analyst typically collaborate with healthcare providers and insurance teams to resolve patient cases?

A Clinical Resolution Analyst frequently acts as a liaison between healthcare providers, insurance teams, and patients to address complex clinical or billing issues. They review medical records, insurance claims, and provider notes to investigate discrepancies or denials, and then communicate findings and solutions to all parties involved. This collaborative process often involves regular meetings, detailed documentation, and coordination with clinical staff to ensure accurate and timely case resolution. Building strong relationships with both internal and external stakeholders is key to success in this role.

What are the key skills and qualifications needed to thrive as a clinical resolution analyst, and why are they important?

To thrive as a Clinical Resolution Analyst, you need a strong background in healthcare administration or clinical practice, analytical thinking, and problem-solving skills, often supported by a relevant degree or certification. Familiarity with electronic health records (EHR) systems, claims processing platforms, and healthcare compliance regulations is crucial. Excellent communication, attention to detail, and the ability to collaborate across departments are important soft skills for this role. These competencies ensure accurate case resolution, regulatory compliance, and effective communication between providers, payers, and patients.

What is a clinical resolution analyst?

A Clinical Resolution Analyst is a healthcare professional who reviews, investigates, and resolves clinical issues or complaints, often related to healthcare claims, patient care, or provider services. They work closely with clinical teams, insurance companies, and patients to ensure accurate and efficient resolution of clinical concerns. Their responsibilities may include analyzing medical records, interpreting clinical guidelines, and communicating outcomes to stakeholders. This role requires strong analytical skills, attention to detail, and knowledge of healthcare regulations and terminology.
What cities near Park Ridge, IL are hiring for Clinical Resolution Analyst jobs? Cities near Park Ridge, IL with the most Clinical Resolution Analyst job openings:
Clinical Resolution Analyst jobs near you

Revenue Integrity Analyst, Full Time - Days

The University of Chicago Medicine

Chicago, IL • On-site

Full-time

Re-posted 4 days ago

University Of Chicago Medicine rating

7.4

Company rating: 7.4 out of 10

Based on 61 frontline employees who took The Breakroom Quiz

265th of 887 rated healthcare providers

Job description


Be a part of a world-class academic healthcare system, Uchicago Medicine, as a Revenue Integrity Analyst in the Revenue Cycle department. This position will be primarily a work from home opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area.
The Revenue Integrity Analyst is responsible for monitoring revenue and usage reports for specific service lines, performing regular charge capture audits and providing a continuous feedback loop of reports, training and education to charge generating departments. Role will have charge reconciliation oversight responsibilities to ensure and document clinical department adherence to policies. This position will also play a key role in optimizing the billing system to reduce errors and increase compliance that includes but is not limited to: working with IT to create workqueue rules/system edits and working with IT/departments to ensure charge capture tools are up-to-date and efficient (e.g. preference lists).
This position maximizes charge efficiency through: (1) Working with departments and IT to implement new or improved charge capture workflows (2) Monitoring and auditing revenue charge capture (3) Providing targeted and timely reports and education to departments (4) Supporting the departments to investigate/identify new revenue opportunities.
  • Implement and promote consistent revenue integrity practices in regards to compliance in coding, billing, and proper documentation
  • Optimize reimbursement working in partnership with departments to further develop the revenue stream and documentation processes
  • Analyzes and assists with correction of billing and coding errors identified by internal and vendor generated pre-billing edits designed to prevent claims delays & denials and non-compliant billing practices
  • Mitigate external audit risks via the practice of audits and continual educational efforts
  • Monitor detailed revenue volumes, Claim Edits, and late charges for the hospital, and provide real time notification to unusual variances
  • Advises regarding proper revenue cycle processes and workflows
  • Assists or advises departments regarding resolution of errors that prevent timely, accurate, and compliant claims submittal
  • Manage regulatory content, simplifying the complex reimbursement environment through promotion and support of consistent operational efficiencies.
  • Help departments to maximize revenue when CPT (Current Procedural Technology) codes for new technologies and services, or change in the payment rates for these and other established services occur

Essential Job Functions
  • Conduct routine quality control charging audits to increase charge capture accuracy and integrity across revenue-generating departments. Identify, root-cause, and resolve any compliance risks. Provide timely feedback and communication to departments
  • Serve as the liaison with the service line clinical leadership team; function as the main revenue cycle point of contact and help colleagues collaborate with the most appropriate revenue cycle team(s) to solve issues. Review billing workflows and works across teams to optimize charge capture and reduce errors and/or omissions.
  • Analyze billing data to identify gaps and areas for opportunity, as well as identify potential compliance risks. Prepare and present departmental summaries that pinpoint opportunities and root cause of issues for service line leaders.
  • Stay apprised of payor and regulatory requirements; provide reports and education for clinical teams to drive user error reduction and adherence to regulatory and organizational policies
  • Coordinate, lead, and facilitate meetings with stakeholders across service lines to review revenue integrity findings to promote accurate and complaint processes, ensure alignment with regulatory and payer requirements, improve charge capture accuracy, and implement changes to improve systemic and/or behavioral workflows to optimize charge capture.
  • Conduct in-depth research on federal, state, and payer-specific regulations to ensure compliance with evolving reimbursement methodologies, coding requirements and charge capture.
  • Prepare and present detailed findings, analyses, and recommendations to service line and revenue cycle leaders and colleagues to inform strategic decision-making and support revenue integrity initiatives.
  • Must have strong issue tracking and resolution skills, and the ability to cope in a fast-paced environment
  • Must be able to prioritize, organize, and assess work in order to meet aggressive deadlines
  • Must be proficient with Microsoft Excel, Word, Visio and PowerPoint
  • Capable of working well in a diverse, multi-disciplinary team and successfully interacting with others at all levels of the organization, including remote teams
  • Excellent interpersonal, written and oral communication skills, and effective presentation skills
  • Ability to plan and facilitate meetings with diverse participants
  • Ability to maintain a professional attitude and demeanor in both normal and pressure situations
  • Proven skills in problem solving
  • Must maintain up-to-date knowledge of healthcare reimbursement regulations, payor policy changes, and industry best practices to proactively identify potential risks and implement corrective actions
  • Must possess strong multitasking skills and have the ability to work and deliver on multiple, complex projects, many of them overlapping

Required Qualifications
  • Bachelor's degree or equivalent work experience/relevant certification in healthcare, business or information systems is required
  • Three to five years' experience in hospital charge capture review, medical record review, and/or claims auditing
  • Minimum two years of coding experience required
  • Must have experience documenting and analyzing business processes

Licenses and Certifications
  • Coding and/or HIM certification OR Bachelor's or Associate's degree in Health Information Management required, Epic credentials or certification preferred

Position Details
  • Job Type/FTE: 1.00 FTE
  • Shift: Days Monday-Friday (No Weekends) 8am-4:30pm (Flexible start time)
  • Unit/Department: Revenue Cycle Management (Burr Ridge, IL)
  • CBA Code: Non-Union

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