Documentation Integrity Analyst

Medasource; Skokie (IL); Remote; USD 41,000 - 48,000; Full time

Job summary

Medasource is seeking a Documentation Integrity Analyst to perform specialized second-level reviews of medical records for high‑risk services.

You will evaluate documentation against payer policies and coding requirements to ensure medical necessity and support audit readiness.

Qualifications

• Interpret and analyze medical record documentation and coding guidelines.
• Proficient with ICD-10, CPT-4, HCPCS coding systems.
• Knowledge of coding research steps to identify code selection.
• Understanding CPT-based coding for inpatient and outpatient reimbursement.
• Ability to prioritize and meet deadlines.
• MS Office proficiency including Access and PowerPoint.
• Experience with Epic Billing and 3M Coding Systems.

Responsibilities

• Perform second-level, pre-service review of high-risk cases against payer policies and regulatory expectations.
• Validate physician orders and documentation for medical necessity.
• Identify missing or unsupported documentation and escalate as needed.
• Coordinate with ordering providers to obtain records and clarify documentation.
• Collaborate with cross-functional teams to resolve complex cases and address payer requirements.
• Maintain accurate case-tracking, outcomes, and turnaround-time records.
• Analyze findings and trends; monitor regulatory changes and audits.
• Develop vascular-focused reference materials and standardized workflows.

Skills

Medical terminology

ICD-10

CPT-4

HCPCS coding

Coding research

Deadline management

MS Office (Access/PowerPoint)

Epic Billing experience

3M Coding Systems

Education

RHIA/RHIT/CCS/CCS-P/CPC/CPS certifications

Associates degree required

Bachelor's degree preferred

Tools

Epic Billing

3M Coding Systems

MS Office

Job description

Job Title: Documentation Integrity Analyst

Hourly/Salary Compensation Range: $30-35

Contract Length: 6 months

Location: Remote

Hours: 8-4:30 CT

Start Date:10/26/26

Job Summary

The Revenue Integrity Analyst is responsible for performing specialized second-level review of medical records for vascular and other assigned high-risk services. The role evaluates clinical documentation, coding requirements, and payer coverage criteria to determine whether the medical record supports the ordered service; coordinates resolution of documentation deficiencies; and supports audit readiness, regulatory compliance, provider education, and continuous process improvement.

Responsibilities

Specialized medical-record and coverage review

Perform second-level, pre-service review of vascular and other assigned high-risk cases against applicable Medicare and commercial payer policies, NCDs, LCDs, coding requirements, and regulatory and audit expectations. Validate that the physician order, progress notes, and supporting clinical documentation are complete, consistent, and sufficient to establish medical necessity.

Documentation-deficiency identification and case disposition

Identify missing, incomplete, inconsistent, or unsupported documentation and determine the appropriate next step in accordance with established workflows. Escalate cases that do not support coverage requirements and facilitate appropriate resolution prior to service or billing whenever possible.

Provider outreach and documentation follow-up

Coordinate with ordering providers and their offices to obtain missing medical records, clarify documentation, and support timely resolution of cases requiring additional information.

Cross-functional case resolution

Collaborate with clinical operations, Coding, Billing, HIM, Revenue Integrity, Compliance, and other stakeholders to resolve complex cases, clarify regulatory or payer requirements, and address recurring documentation or coverage concerns.

Review tracking and audit documentation

Maintain accurate records of cases reviewed, identified deficiencies, provider outreach, determinations, outcomes, turnaround times, corrective actions, and recurring areas of risk.

Reporting and trend analysis

Analyze and summarize review findings, documentation trends, audit risks, and workflow outcomes.

Regulatory and payer-policy monitoring

Monitor changes in Medicare regulations, payer policies, NCDs, LCDs, and applicable coding or documentation requirements. Incorporate relevant changes into review criteria, workflows, and reference materials.

Education and process improvement

Develop and maintain vascular-specific and other assigned clinical reference materials, documentation guidance, educational resources, and standardized workflows.

Qualifications

• The ability to interpret and analyze medical record documentation, encounter forms, and lab reports, Explanation of Benefits, CMS claim forms, third party payor guidelines and government regulations.
• Aptitude for medical terminology, ICD-10, CPT-4, and HCPCS coding systems.
• Knowledge of research steps utilized to identify appropriate code selection or billing requirements.
• Working knowledge of CPT-based coding principles from both an inpatient and outpatient reimbursement perspective, UB-04, MA claim form, and the HCFA-1500, charging processes and compliance issues.
• Ability to prioritize and organize workload and meet deadlines.
• Proficiency in MS Office’s suite of products, including Access and PowerPoint, and the internet.
• Experience with Epic Billing and 3M Coding Systems.

Education/Licences/Certifications

RHIA, RHIT, CCS-P, CCS, CPS, or CPC: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Coder (CPC), or Certified Professional Services Coder (CPS); up to 10 years of directly related professional experience may be considered in lieu of the stated licenses/certification requirements.

Associates Required, Bachelors Preferred.

2 years experience in Revenue Cycle required