Revenue Integrity Analyst (Medical Biller)
About The Position
Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD’s enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Support and optimize MHS GENESIS revenue cycle configuration, including charge capture workflows, billing rules, and work queues. Validate charge accuracy, coding logic, modifiers, and payer requirements; troubleshoot system and workflow issues. Analyze financial, clinical, and operational data to identify trends, charge variances, and revenue improvement opportunities. Investigate claim edits and denials, identify root causes, and coordinate corrections with clinical and coding teams. Reconcile clinical activity to billing outputs and improve charge capture and CDM workflows. Perform chart‑to‑bill audits to ensure documentation, coding (CPT, ICD‑10, HCPCS), and billing compliance. Educate staff on proper coding, documentation, and revenue cycle best practices; support multidisciplinary workgroups. Recommend process and workflow improvements to reduce denials, enhance compliance, and support system‑wide standardization.
Requirements
- Must be able to OBTAIN and MAINTAIN a Federal or DoD "PUBLIC TRUST"; candidates must obtain approved adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE PUBLIC TRUST or SUITABILITY are preferred.
- Bachelors Degree
- FOUR (4) or more years of Revenue Cycle Management (RCM) build experience, including troubleshooting, system reconfiguration, and/or project management.
Nice To Haves
- Bachelor’s Degree in Business, Management, Healthcare Administration, Business Analysis, Statistics, or related field
- Strong working knowledge of CPT, ICD‑10, and HCPCS Level II coding systems.
- Understanding of Chargemaster (CDM) structure and charge reconciliation processes.
- Experience with EHR systems such as Oracle Health (Cerner) or MHS GENESIS, including encounter review and charge workflows.
- Familiarity with claim scrubber tools, billing systems, and payer edit logic.
- Strong analytical and critical‑thinking skills with ability to interpret complex data.
- Effective communication skills with the ability to train, educate, and influence stakeholders.
- Understanding of healthcare billing, medical necessity, and revenue cycle operations.
- Experience working within the Military Health System (MHS) or other federal health systems.
- Background in hospital or professional billing environments.
- Certifications such as CPC, CCS, CPMA, or RHIT/RHIA.
- Prior consulting experience or participation in large‑scale EHR or revenue cycle implementations
Responsibilities
- Support and optimize MHS GENESIS revenue cycle configuration, including charge capture workflows, billing rules, and work queues.
- Validate charge accuracy, coding logic, modifiers, and payer requirements; troubleshoot system and workflow issues.
- Analyze financial, clinical, and operational data to identify trends, charge variances, and revenue improvement opportunities.
- Investigate claim edits and denials, identify root causes, and coordinate corrections with clinical and coding teams.
- Reconcile clinical activity to billing outputs and improve charge capture and CDM workflows.
- Perform chart‑to‑bill audits to ensure documentation, coding (CPT, ICD‑10, HCPCS), and billing compliance.
- Educate staff on proper coding, documentation, and revenue cycle best practices; support multidisciplinary workgroups.
- Recommend process and workflow improvements to reduce denials, enhance compliance, and support system‑wide standardization.
Benefits
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave and Adoption Assistance
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Student Loan PayDown
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
- Mobility Stipend
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
