Revenue Integrity Analyst: Revenue Analytics & Optimization

Sioux Center Health; Sioux Falls (SD); On-site; USD 35,000 - 53,000; Full time

Benefits offered by this job

PTO from day 1

Retirement match (up to 5%)

Career development and mentorship

Job summary

Avera is seeking a Revenue Integrity Analyst to enhance financial performance by ensuring accurate charge capture and appropriate reimbursement across the revenue cycle. You will join a multidisciplinary team, leveraging analytics, audits, and payment integrity to support decision-making and compliance.

You will design dashboards, conduct audits, monitor DNB accounts, investigate denials, manage appeals, and collaborate with clinical, billing, and payer relations teams to drive continuous

Qualifications

• Associate's degree or higher 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 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 elevate discrepancies as needed.
• Oversee Post-Service 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.

Education

Associate's in Healthcare Administration, Finance, Business Analytics, or related field

Two to three years experience in healthcare revenue cycle analytics, charge auditing, or payment integrity

Knowledge of healthcare billing, denial management, and/or payer reimbursement methodologies

Tools

Power BI

Tableau

Excel

Epic reporting tools

Job description

Avera is seeking a Revenue Integrity Analyst to enhance financial performance by ensuring accurate charge capture and appropriate reimbursement across the revenue cycle. You will join a multidisciplinary team, leveraging analytics, audits, and payment integrity to support decision-making and compliance.

You will design dashboards, conduct audits, monitor DNB accounts, investigate denials, manage appeals, and collaborate with clinical, billing, and payer relations teams to drive continuous