Senior Revenue Integrity Analyst – Remote Governance

Northwestern Medicine; United States; Remote; USD 55,000 - 80,000; Full time

Benefits offered by this job

Tuition Reimbursement

Student Loan Repayment

Professional Development

Wellbeing Fund

Matching 401(k)

Medical/Dental/Vision coverage

Life insurance

Annual salary increase and incentive

Paid time off and holidays

Job summary

Northwestern Medicine is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle with charge capture analysis, maintaining the charge master for accuracy and compliance, and preparing management-ready analyses.

The role involves leading audits, identifying opportunities, interpreting CPT/HCPCS/ICD-10 rules, collaborating with IT to link EPIC to the charge master, and mentoring the Revenue Integrity Team while upholding regulatory standards.

Qualifications

• Bachelor’s Degree in Business or related field or 10 years of equivalent experience.
• 5+ years in revenue cycle or revenue integrity role.
• Advanced understanding of CPT, HCPCS, ICD-10, and third party billing requirements.
• Extensive knowledge and experience with Medicare/Medicaid regulations.
• Strong communication, collaboration, and analytical skills.
• Requires critical thinking, decisive judgment, high attention to detail and ability to work with minimal supervision.
• EPIC Certification (Resolute Charge Capture) and EPIC Certification (Clarity Report Data) preferred.
• Master’s degree in Healthcare Management, Business, MIS, Data Analytics, or related field.
• Beginner to Moderate knowledge of SQL and relational databases.
• RHIA or related health care credential preferred.

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Proactively identify charge capture opportunities in all revenue producing departments.
• Research and interpret billing and coding regulations, communicate to impacted areas, and apply changes that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Lead quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy.
• Lead efforts to assess, modify, and/or develop and implement more timely and consistent processes/systems to increase efficiency, accuracy, and meaningfulness of information.
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Mentors and supports members of Revenue Integrity Team as an informal leader.

Skills

5+ years in revenue cycle or revenue

Advanced CPT/HCPCS/ICD-10 knowledge

Medicare/Medicaid regulations

Strong communication and analytical

Critical thinking and detail-oriented

Education

Bachelor’s Degree in Business or related field

RHIA or related health care credential

Master’s degree in Healthcare Management, Business, MIS, Data Analytics, or related field

Tools

Microsoft Office

EPIC Certification (Resolute Charge Capture)

EPIC Certification (Clarity Report Data)

SQL (beginner to moderate)

Job description

Northwestern Medicine is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle with charge capture analysis, maintaining the charge master for accuracy and compliance, and preparing management-ready analyses.

The role involves leading audits, identifying opportunities, interpreting CPT/HCPCS/ICD-10 rules, collaborating with IT to link EPIC to the charge master, and mentoring the Revenue Integrity Team while upholding regulatory standards.