Revenue Integrity Analyst

TEKsystems•Chesapeake, VA

1d•Hybrid

About The Position

The Revenue Integrity Analyst supports accurate hospital billing and revenue capture by reviewing charges against medical record documentation, resolving billing edits, and identifying missed or incorrect charges. This role partners closely with clinical departments, billing teams, and revenue cycle leadership to prevent revenue leakage, ensure compliance, and improve charge capture processes. This is an ideal opportunity for a highly seasoned coder or revenue integrity professional, especially someone with strong outpatient coding experience and recent hospital experience.

Requirements

Sr.‑level coding experience in an acute care hospital setting (recent hospital experience required)
Strong outpatient coding experience highly preferred
CPC certification required
Advanced knowledge of ICD‑10‑CM, CPT, and HCPCS coding
Knowledge of Medicare, Medicaid, and commercial payer guidelines
Strong understanding of charge capture, billing audits, and revenue integrity processes
Demonstrated ability to analyze data, identify trends, and resolve issues independently
Excellent written and verbal communication skills; ability to work cross‑functionally
Proficiency with hospital information systems and computer technology
RN with extensive ICU, Emergency Department, or nurse auditor/documentation experience
LPN with a combined coding and auditing background

Responsibilities

Manage and prioritize multiple work queues related to charge capture and coding edits
Review and resolve NCD/LCD, MUE, and CCI edits to ensure compliant billing
Perform Charge Capture Audits (CCA) to identify missed or incorrect charges
Review observation and extended recovery encounters, including infusion and injection services
Audit itemized charges against medical record documentation prior to billing
Research and resolve billing edits for medical necessity and payer compliance
Assign appropriate HCPCS codes and modifiers and advise billing teams accordingly
Review payer remittance advice and remark/reason codes to prevent future denials
Identify denial trends, perform root‑cause analysis, and support prevention efforts
Maintain 95% or greater accuracy while meeting productivity standards
Serve as a subject matter resource for clinical departments on charge capture and billing issues
Partner with revenue‑producing departments to identify lost or inaccurate charges
Educate departments on recurring documentation, coding, and charge capture issues
Communicate trends and findings to leadership to support continuous improvement
Collaborate with Patient Financial Services, HIM, Internal Audit, Regulatory Review, and external consultants
Maintain audit activity reports and track trends and patterns
Assist with RAC requests, coding reviews, and denials support
Participate in required training, meetings, and continuing education
Perform additional revenue integrity or billing‑related duties as assigned