Revenue Integrity Analyst

Grand River Health Main Campus•Rifle, CO

3d•Onsite

About The Position

This position supports the Revenue Cycle as a whole, ensuring accurate registration, documentation, charge capture, billing, and payment processes while identifying opportunities to improve revenue integrity. Review charges and clinical documentation prior to billing to ensure accuracy, compliance, and charge capture integrity. Partner with providers, staff, and department leaders to implement best practices for charging, coding, documentation, and billing. Maintain the integrity of the Charge Description Master (CDM), including coordinating regular reviews of CPT changes and compliance requirements. Coordinate retrospective, concurrent, patient complaint, and external billing audits; document findings, support appeals, and provide monthly audit reporting. Analyze denial and unclean claim trends, identify process improvement opportunities, and develop educational in-services related to documentation, charging, and billing. Perform a variety of tasks and other duties as assigned.

Requirements

Bachelor's degree in a related field preferred.
High school diploma or equivalent preferred; LPN, RN, RHIA, RHIT, CCS, or related certification preferred.
0–6 years of healthcare experience required; experience in case management, clinical services, coding, or clinical documentation preferred.
Strong verbal and written communication, interpersonal, problem-solving, and customer service skills.
Working knowledge of Microsoft Word, Excel, Outlook, medical terminology, HIPAA, patient confidentiality, and healthcare reimbursement methodologies.
Strong attention to detail with the ability to maintain accuracy, learn new processes, retain information, and adapt to new tasks and software.

Nice To Haves

Detail-oriented professional with healthcare experience and an interest in revenue cycle, clinical documentation, and compliance.
Communicates effectively, learns quickly, and can build strong relationships while maintaining accuracy and confidentiality.

Responsibilities

Review charges and clinical documentation prior to billing to ensure accuracy, compliance, and charge capture integrity.
Partner with providers, staff, and department leaders to implement best practices for charging, coding, documentation, and billing.
Maintain the integrity of the Charge Description Master (CDM), including coordinating regular reviews of CPT changes and compliance requirements.
Coordinate retrospective, concurrent, patient complaint, and external billing audits; document findings, support appeals, and provide monthly audit reporting.
Analyze denial and unclean claim trends, identify process improvement opportunities, and develop educational in-services related to documentation, charging, and billing.
Perform a variety of tasks and other duties as assigned.