Revenue Integrity & Reimbursement Analyst

WVU Medicine; Oregon; Hybrid; USD 65,000 - 95,000; Full time

Job summary

SYSTEM West Virginia University Health System in Oregon seeks a billing/revenue cycle professional to review charge edits and maximize reimbursement. You will coordinate with leadership to optimize Epic Revenue Guardian tooling and ensure compliance with payer policies.

The role requires 2+ years of billing experience; a high school diploma is required, with a bachelor's degree preferred. Excellent analytical, communication, and computer skills are essential.

Qualifications

• High School Diploma or equivalent required.
• 2+ years billing/revenue cycle experience preferred.
• Bachelor's degree in business or health IT preferred.

Responsibilities

• Manages payor and claim edits (CCI, OCE, MUE, LCD/NCD) to ensure compliant, timely edits.
• Tracks edited accounts, actions, and outcomes; reports trends to leadership.
• Monitors denials and follow-up activities related to billing edits.
• Assists departments on compliance with government regulations for claim edits.
• Collaborates with Revenue Cycle leadership and departments to optimize charge capture.
• Keeps knowledge of payer policies and regulations; communicates updates to leadership.
• Performs root-cause analyses to reduce high-volume edits and routing errors.

Skills

Medical terminology

ICD-10/CPT codes

Analytical skills

Excel

Communication skills

Computer literacy

Education

High School Diploma or equivalent

Bachelor's degree in healthcare related field / Health IT

Job description

SYSTEM West Virginia University Health System in Oregon seeks a billing/revenue cycle professional to review charge edits and maximize reimbursement. You will coordinate with leadership to optimize Epic Revenue Guardian tooling and ensure compliance with payer policies.

The role requires 2+ years of billing experience; a high school diploma is required, with a bachelor's degree preferred. Excellent analytical, communication, and computer skills are essential.