Revenue Integrity Lead: Charge Capture & Compliance

Northeast Georgia Health System; New York (NY); On-site; USD 110,000 - 150,000; Full time

Job summary

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

Lead audits, support governance, and drive revenue optimization initiatives across clinical departments while ensuring alignment with CMS and payer requirements. The role emphasizes data-driven analysis, cross-functional collaboration, and education across teams to improve financial performance.

Qualifications

• Must have a Bachelor's degree in a health or related field.
• Minimum 5+ years in hospital revenue cycle, charge capture, or CDM.
• Combination of relevant certifications and work experience may substitute for the degree.

Responsibilities

• Monitor departmental charge capture accuracy and analyze work queues.
• Identify charge capture gaps and 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 mappings and rules.
• Analyze trends and root causes affecting reimbursement and financial performance.
• Quantify revenue at risk and develop corrective action plans.
• Ensure CMS and regulatory compliance.
• Support CPT/HCPCS annual updates.
• Collaborate with Coding, IT, Finance, Compliance and leadership to improve processes.
• Support governance committees.
• Develop reports and dashboards and deliver data-driven recommendations.
• Performs other duties as assigned.

Skills

CPT/HCPCS knowledge

CDM structure

Auditing & compliance

Financial impact analysis

Workflow redesign

Excel & data analysis

Training & education

Cross-functional communication

CMS/Medicaid/payor rules

Dashboards & reporting

Education

Bachelor's Degree

Job description

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

Lead audits, support governance, and drive revenue optimization initiatives across clinical departments while ensuring alignment with CMS and payer requirements. The role emphasizes data-driven analysis, cross-functional collaboration, and education across teams to improve financial performance.