Revenue Integrity Analyst: Data-Driven Billing & Compliance

Sioux Center Health; Sioux Falls (SD); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

PTO from day 1

Employer retirement match up to 5%

Job summary

Avera is seeking a Revenue Integrity Analyst in Sioux Falls to enhance financial performance by ensuring accurate charge capture and appropriate reimbursement across the revenue cycle. This role collaborates with clinical, billing, coding, IT, and payer relations teams to identify trends, resolve discrepancies, and drive continuous improvement in HB and PB services.

You will design dashboards, conduct audits, monitor DNB accounts, investigate denials, manage appeals, and oversee SCAs to ensure

Qualifications

• Associate's in Healthcare Administration, Finance, Business Analytics, or related field and/or 2-3 years of healthcare revenue cycle analytics.
• Two to three years experience in healthcare revenue cycle analytics, charge auditing, or payment integrity.
• Knowledge of healthcare billing, denial management, and payer reimbursement methodologies.
• Bachelor's degree preferred.
• HFMA CRCR or HFMA CSPR certification upon hire.
• Proficiency in data visualization tools (Power BI, Tableau) and Excel.
• Experience with Epic reporting tools (SlicerDicer, Reporting Workbench, Clarity, billing modules).

Responsibilities

• Design, maintain, and enhance dashboards and scorecards for denials, write-offs, payer performance, and charge activity.
• Conduct audits and Revenue Guardian checks to validate charge accuracy and completeness.
• Monitor and resolve Discharged Not Billed (DNB) accounts to ensure timely claim submission.
• Investigate denials and underpayments, identify root causes, and recommend process improvements.
• Manage appeals for underpaid claims, track outcomes, and report on recovery efforts and payment trends.
• Review high-dollar write-offs for appropriateness and escalation discrepancies as needed.
• Oversee Post-Service Single Case Agreements (SCAs) to ensure reimbursement accuracy and adherence to contract terms.
• Partner with clinical, operational, and payer relations teams to resolve discrepancies and improve documentation.
• Participate in audits, strategic initiatives, and projects aimed at financial optimization and revenue integrity.

Skills

Revenue cycle analytics

Charge auditing

Payment integrity

Data interpretation

Communication

Education

Associate's degree

Bachelor's degree

HFMA CRCR

HFMA CSPR

Tools

Power BI

Tableau

Epic reporting tools

Job description

Avera is seeking a Revenue Integrity Analyst in Sioux Falls to enhance financial performance by ensuring accurate charge capture and appropriate reimbursement across the revenue cycle. This role collaborates with clinical, billing, coding, IT, and payer relations teams to identify trends, resolve discrepancies, and drive continuous improvement in HB and PB services.

You will design dashboards, conduct audits, monitor DNB accounts, investigate denials, manage appeals, and oversee SCAs to ensure