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Revenue Integrity Coding Analyst Jobs in Tennessee

Vertek Staffing

Revenue Integrity Analyst

Franklin, TN · Remote

The analyst will work closely with Revenue Integrity, Patient Financial Services, HIM, Coding, Clinical Departments, CDI, and Information Technology teams to support compliant billing practices and ...

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Revenue Integrity Coding Analyst information

What kind of jobs in media bring in $150,000 a year?

In media, high-paying roles such as senior media planners, media directors, or advertising executives can earn $150,000 or more annually. These positions typically require extensive experience, strong negotiation skills, and proficiency with industry tools like media planning software.

What is a revenue integrity coder?

A revenue integrity coder is a professional responsible for reviewing and coding healthcare claims to ensure accurate billing and compliance with regulations. They analyze medical records, assign appropriate codes, and work to prevent revenue loss due to errors or discrepancies, often using coding systems like ICD-10 and CPT. Strong attention to detail and knowledge of healthcare billing are essential for this role.

What does a revenue integrity analyst do?

A revenue integrity analyst reviews and audits healthcare billing and coding to ensure accurate revenue capture and compliance with regulations. They analyze data, identify discrepancies, and implement process improvements using coding systems and revenue cycle management tools to optimize financial performance.

How much does a RCM specialist make in the US?

A Revenue Cycle Management (RCM) specialist typically earns between $45,000 and $65,000 annually in the US, depending on experience, location, and certifications. Salaries can vary based on the complexity of coding tasks, healthcare setting, and additional skills such as familiarity with coding software or billing systems.

What is a Revenue Integrity Coding Analyst?

A Revenue Integrity Coding Analyst is a healthcare professional responsible for ensuring that medical coding and billing practices comply with regulations and maximize appropriate revenue for healthcare organizations. They review clinical documentation, coding, and billing data to identify discrepancies or errors that could impact reimbursement. Their role often involves analyzing trends, implementing process improvements, and working closely with clinical and billing staff to ensure accurate and compliant revenue cycle management. By doing so, they help prevent revenue loss and minimize the risk of audits or penalties.

What is the difference between Revenue Integrity Coding Analyst vs Revenue Cycle Specialist?

AspectRevenue Integrity Coding AnalystRevenue Cycle Specialist
CertificationsCPH, CCS, CPCCPH, CPC, RHIT
Work EnvironmentHospital, outpatient, billing departmentsHospital, billing, insurance
Primary FocusEnsuring accurate coding and complianceManaging entire revenue cycle process

The Revenue Integrity Coding Analyst primarily focuses on accurate coding and compliance to optimize revenue, while the Revenue Cycle Specialist manages the broader revenue cycle, including billing and collections. Both roles require similar certifications and work in healthcare settings, but their core responsibilities differ, making them distinct yet related positions in healthcare revenue management.

What are the key skills and qualifications needed to thrive as a Revenue Integrity Coding Analyst, and why are they important?

To thrive as a Revenue Integrity Coding Analyst, you need a strong understanding of medical coding, billing regulations, and healthcare reimbursement systems, often supported by certifications such as CPC or CCS. Familiarity with coding software, electronic health records (EHR), and audit tools is typically required. Attention to detail, analytical thinking, and effective communication are standout soft skills in this role. These competencies are vital to ensure accurate coding, compliance, and optimal revenue capture for healthcare organizations.

How does a Revenue Integrity Coding Analyst typically collaborate with clinical and billing teams to ensure accurate revenue capture?

Revenue Integrity Coding Analysts work closely with both clinical staff and billing departments to ensure medical codes are applied accurately and efficiently. They often review clinical documentation, clarify ambiguities with physicians, and communicate any coding discrepancies to billing teams. This collaboration helps prevent revenue leakage, supports compliance with regulations, and ensures timely and accurate reimbursement. Regular meetings and feedback sessions are common to address ongoing coding challenges and implement process improvements.
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Revenue Integrity Coding Analyst jobs near you
Revenue Integrity Analyst

Revenue Integrity Analyst

Vertek Staffing

Franklin, TN • Remote

Contractor

Re-posted 13 days ago

Job description

Healthcare Revenue Integrity Analyst - Edits & Charge Capture | Remote | Contract

Schedule: Monday - Friday | Full-Time

Position Summary

The Healthcare Revenue Integrity Analyst is responsible for reviewing, analyzing, and resolving billing edits, charge review exceptions, and revenue cycle discrepancies to ensure accurate reimbursement and regulatory compliance. This role serves as a key resource in identifying revenue leakage opportunities, improving charge capture processes, reducing denials, and optimizing revenue cycle performance.

The analyst will work closely with Revenue Integrity, Patient Financial Services, HIM, Coding, Clinical Departments, CDI, and Information Technology teams to support compliant billing practices and maximize reimbursement.

Required Qualifications

  • Minimum 3 years of Revenue Integrity, Revenue Cycle, Billing, Coding, or Charge Capture experience within a hospital or health system.
  • Experience working claim edit workqueues and billing edits.
  • Knowledge of Medicare, Medicaid, and commercial payer reimbursement methodologies.
  • Experience researching and resolving charging, coding, and billing discrepancies.
  • Understanding of NCCI edits, medical necessity edits, modifier usage, and reimbursement guidelines.
  • Experience with Epic Resolute, Epic Revenue Integrity, Cerner, Meditech, or similar hospital billing systems.
  • Strong analytical and problem-solving skills.

Preferred Certifications
One or more of the following certifications is preferred:

  • CPMA (Certified Professional Medical Auditor)
  • CPC (Certified Professional Coder)
  • COC (Certified Outpatient Coder)
  • CCS (Certified Coding Specialist)
  • CRCR (Certified Revenue Cycle Representative)
  • RHIT (Registered Health Information Technician)
  • RHIA (Registered Health Information Administrator)

Primary Responsibilities

  • Review and resolve claim edits and billing exceptions.
  • Analyze charging and reimbursement issues impacting revenue cycle performance.
  • Identify trends related to denials, underpayments, and revenue leakage.
  • Collaborate with Coding, CDI, Revenue Cycle, Clinical Departments, and Patient Financial Services to resolve reimbursement issues.
  • Validate compliance with payer regulations, CMS guidelines, and organizational policies.
  • Support charge capture improvement initiatives and CDM maintenance activities.
  • Perform root cause analysis on recurring billing and reimbursement issues.
  • Assist with revenue cycle audits and process improvement initiatives.
  • Develop recommendations to improve clean claim rates and reduce denials.
  • Monitor and report key revenue integrity performance metrics.

Preferred Background
Candidates with experience in Revenue Integrity, Charge Capture, Revenue Cycle Analytics, Denials Management, Patient Financial Services, Hospital Billing, or HIM Operations are strongly encouraged to apply.

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About Vertek Solutions

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Vertek Solutions is a boutique staffing firm that specializes in recruiting top level IT talent who can enhance our clients’ teams. Our team works every day to foster relationships with both our consultants and clients to understand their needs and ensure that we are providing a solution that is mutually beneficial.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Franklin, TN, US

Year founded

2006

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