Revenue Integrity Analyst: Optimize Reimbursement & Denials

Avera Health; Sioux Falls (SD); On-site; USD 73,068,000 - 109,602,000; Full time

Benefits offered by this job

PTO from day 1

5% retirement match

Career development and mentorship

Equal Opportunity Employer

Job summary

Avera is seeking a Revenue Integrity Analyst to enhance financial performance across hospital and professional billing. You will design dashboards, perform denials and charge audits, and assess payer performance to drive accurate reimbursement.

You will collaborate with clinical, billing, IT, and payer relations teams to identify trends, resolve discrepancies, monitor DNB, handle appeals, and support continuous improvement in the revenue cycle.

Qualifications

• Associate's degree in healthcare administration, finance, business analytics, or related field.
• 2-3 years of experience in healthcare revenue cycle analytics, charge auditing, or payment integrity.
• Knowledge of healthcare billing, denial management, and payer reimbursement methodologies.

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 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 trends.
• Review high-dollar write-offs for appropriateness and escalate discrepancies as needed.
• Oversee Post-Service SCAs to ensure reimbursement accuracy and contract terms.
• Partner with clinical, operational, and payer relations teams to resolve discrepancies and improve documentation.

Skills

Revenue cycle analytics

Charge auditing

Payment integrity

Payer reimbursement

Data visualization

Education

Associate's degree in Healthcare Administration/Finance/Analytics

Bachelor's degree or HFMA certifications (preferred)

Tools

Power BI

Tableau

Epic reporting tools

Job description

Avera is seeking a Revenue Integrity Analyst to enhance financial performance across hospital and professional billing. You will design dashboards, perform denials and charge audits, and assess payer performance to drive accurate reimbursement.

You will collaborate with clinical, billing, IT, and payer relations teams to identify trends, resolve discrepancies, monitor DNB, handle appeals, and support continuous improvement in the revenue cycle.