Revenue Integrity Analyst: Charge Capture & Compliance

Care New England; Warwick (RI); On-site; USD 65,000 - 90,000; Full time

Job summary

Care New England is seeking a Revenue Integrity Charge Capture specialist to ensure complete and accurate hospital and professional charges. You will monitor Epic Revenue Guardian, reconcile documentation to charges, and collaborate with coding and clinical teams to meet CMS, Medicare, and payer guidelines.

The role focuses on reducing revenue leakage, auditing charge workflows, and supporting compliant billing across the organization.

Qualifications

• Strong working knowledge of CPT, HCPCS, and ICD-10 coding systems and their application to charge capture and reimbursement.
• Comprehensive understanding of healthcare revenue cycle operations, particularly front-end processes and professional/facility charge capture.
• Familiarity with Medicare, Medicaid, and commercial payer billing and reimbursement guidelines.
• In-depth knowledge of Epic or comparable EHR/EMR systems, including work queues and Revenue Guardian reporting tools.
• Understanding of compliance regulations including HIPAA and CMS guidelines related to billing practices.

Responsibilities

• Review daily Epic Revenue Guardian reports and charge-related work queues to identify and correct missing, incomplete, or inaccurate charges.
• Validate charge capture processes are functioning as expected and elevate systemic issues to the Manager of Revenue Integrity.
• Reconcile clinical documentation against charge activity to ensure all services rendered are accurately reflected and captured.
• Collaborate with clinical departments to clarify documentation discrepancies or omissions impacting charging.
• Maintain working knowledge of payor billing guidelines and apply accurate CPT, HCPCS, and ICD-10 codes during charge validation.

Skills

CPT coding

HCPCS coding

ICD-10 coding

Epic Revenue Guardian

Revenue cycle knowledge

Excel

Communication skills

HIPAA compliance

Education

High School diploma or GED

Associate's Degree preferred

Tools

Epic EHR

Revenue Guardian reporting tools

Job description

Care New England is seeking a Revenue Integrity Charge Capture specialist to ensure complete and accurate hospital and professional charges. You will monitor Epic Revenue Guardian, reconcile documentation to charges, and collaborate with coding and clinical teams to meet CMS, Medicare, and payer guidelines.

The role focuses on reducing revenue leakage, auditing charge workflows, and supporting compliant billing across the organization.