Revenue Cycle Integrity Specialist

Highmark Health; Northern (KY); Hybrid; USD 59,000 - 92,000; Full time

Job summary

Allegheny Health Network is seeking a Revenue Cycle Analyst to perform reporting and analysis of the revenue cycle, assist with system issues, audits, and education for staff. This role collaborates with leadership to optimize documentation, billing processes, and internal controls, supporting compliance across the organization.

The position emphasizes liaison duties, regulatory risk assessment, and continuous improvement in the Revenue Cycle with cross-functional partners.

Qualifications

• Minimum High School/GED with 1–3 years in hospital or physician revenue cycle, billing or coding.
• Bachelor's degree in Business, Healthcare or related field preferred.
• 1 year in Project Management; 1 year in Epic-billing environment.

Responsibilities

• Present detailed analysis of A/R performance and other financial reports and trends.
• Research and validate clinical data used to support medical necessity of billed services.
• Conduct quality assurance reviews of billing components, technical requirements, supporting processes, systems and documentation.
• Assist with maintaining the integrity of the CDM (charge description master) and the software program.
• Coordinate RAC and payer audit appeals with Compliance and leadership.
• Provide ongoing education to departments and RCC staff concerning revenue cycle processes and policies.
• Develop and maintain a Quality Audit program and related reporting.

Skills

Revenue cycle experience

Project management experience

Education

High School Diploma or GED

Bachelor's Degree in Business, Healthcare or related field

Tools

Epic-billing environment

Job description

Allegheny Health Network is seeking a Revenue Cycle Analyst to perform reporting and analysis of the revenue cycle, assist with system issues, audits, and education for staff. This role collaborates with leadership to optimize documentation, billing processes, and internal controls, supporting compliance across the organization.

The position emphasizes liaison duties, regulatory risk assessment, and continuous improvement in the Revenue Cycle with cross-functional partners.