Revenue Integrity Lead: Charge Capture & Compliance

Northeast Georgia Health System; Georgia; Vor Ort; USD 90.000 - 130.000; Vollzeit

Zusammenfassung

Northeast Georgia Health System is seeking a Sr. Revenue Integrity Analyst to provide subject matter expertise in charge capture, CDM application, compliance, and reimbursement.

You will lead audits, support governance, and drive revenue optimization across clinical departments while ensuring alignment with CMS and payer requirements. In this role, you will monitor charge capture performance, identify gaps, and deliver training across clinical teams.

Qualifikationen

• Bachelor's Degree required.
• 5+ years in hospital revenue cycle, charge capture, or CDM.
• A combination of relevant certification(s) and demonstrated work experience may substitute for the required degree.

Aufgaben

• Monitor departmental charge capture accuracy and reconcile reports.
• Identify charge capture gaps, workflow issues, and systemic revenue loss risks.
• Provide guidance, training, and education to clinical departments.
• Partner with CDM team on updates and improvements.
• Conduct pre/post bill audits to validate charge mappings and billing rules.
• Analyze trends and root causes impacting reimbursement and financial performance.
• Quantify revenue at risk and develop corrective action plans to optimize revenue initiatives.
• Ensure CMS and regulatory compliance.
• Support CPT/HCPCS annual updates.
• Collaborate with Coding, IT, Finance, Compliance and leadership to resolve issues.
• Develop reports and dashboards and deliver data-driven recommendations to leadership.

Kenntnisse

Charge capture

CDM application

Auditing

Data analysis

Advanced Excel

Training/education

Cross-functional communication

CMS/payor rules

Dashboards/reporting

Ausbildung

Bachelor's Degree

Tools

Epic Certification

Dashboard reporting tools

Jobbeschreibung

Northeast Georgia Health System is seeking a Sr. Revenue Integrity Analyst to provide subject matter expertise in charge capture, CDM application, compliance, and reimbursement.

You will lead audits, support governance, and drive revenue optimization across clinical departments while ensuring alignment with CMS and payer requirements. In this role, you will monitor charge capture performance, identify gaps, and deliver training across clinical teams.