Revenue Integrity Analyst

Horizon Health•Howard, SD

5h•Hybrid

About The Position

Horizon Health in any Horizon location is seeking a full-time Revenue Integrity Analyst. The Revenue Integrity Analyst is responsible for monitoring, analyzing, and improving the organization’s revenue cycle processes to ensure accurate reimbursement, compliant billing practices, and optimization of revenue opportunities. The Revenue Integrity Analyst identifies revenue leakages, payer reimbursement issues, charge capture deficiencies, and workflow inefficiencies. They proactively monitor revenue performance, investigate reimbursement variances, identify root cause of denials and underpayments, conduct audits, and develop corrective action plans that improve financial outcomes while ensuring regulatory compliance. Horizon Health offers a collaborative, team-oriented work environment focused on meeting the needs of individual patients while supporting and contributing to the health and wellness of our communities. Position may be remote eligible for the right candidate.

Requirements

Monitoring, analyzing, and improving the organization’s revenue cycle processes.
Ensuring accurate reimbursement.
Ensuring compliant billing practices.
Optimization of revenue opportunities.
Identifying revenue leakages, payer reimbursement issues, charge capture deficiencies, and workflow inefficiencies.
Proactively monitoring revenue performance.
Investigating reimbursement variances.
Identifying root cause of denials and underpayments.
Conducting audits.
Developing corrective action plans that improve financial outcomes while ensuring regulatory compliance.

Nice To Haves

Remote eligible for the right candidate.

Responsibilities

Audit Medicare, Medicaid, Medicare Advantage, Commercial, and Managed Medicaid claims for reimbursement accuracy.
Audit remittance advice data for payer compliance with contractual reimbursement requirements and ensure payer paid correct allowed amount per payer fee schedule.
Monitor denials, underpayments, charge lag, claim edits, and payment variances.