Job Category:
Revenue Cycle
Work Shift/Schedule:
8 Hr Morning - Afternoon
Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.
About the Role:
Job Summary
The Sr. Revenue Integrity Analyst provides subject matter expertise in charge capture, CDM application, compliance, and reimbursement. The Sr. Revenue Integrity Analyst leads audits, supports governance, and drives revenue optimization initiatives across clinical departments while ensuring alignment with CMS and payer requirements.
Minimum Job Qualifications
Licensure or other certifications:
Educational Requirements:
Bachelors Degree
Minimum Experience:
5+ years hospital revenue cycle, charge capture, or CDM
Other:
A combination of relevant certification(s) and demonstrated work experience may substitute for the required degree.
Preferred Job Qualifications
Preferred Licensure or other certifications:
CPC, CCS, RHIT/RHIA, Epic Certification.
Preferred Educational Requirements:
Preferred Experience:
Other:
Job Specific and Unique Knowledge, Skills and Abilities
Advanced knowledge of CPT/HCPCS and reimbursement
Expertise in CDM structure and clinical application
Strong auditing and compliance background
Ability to analyze financial impact of charge issues
Experience with workflow redesign and optimization
Advanced Excel and data analysis skills
Ability to lead training and education initiatives
Strong communication across clinical and executive teams
Knowledge of CMS, Medicaid, and payor rules
Experience with dashboards and reporting
Essential Tasks and Responsibilities
Monitor departmental charge capture accuracy to ensure thorough analysis of work queues and reconciliation 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 recommend improvements
Conduct pre/post bill audits to validate charge mappings and billing rules.
Analyze trends and root causes impacting reimbursement, compliance, and financial performance.
Quantify revenue at risk and assess the financial impact of charge and develop corrective action plans to optimize revenue initiatives.
Ensure CMS and regulatory compliance
Support CPT/HCPCS annual updates
Collaborate cross-functionally with Coding, IT, Finanace, Compliance and leadership to resolve issues and improve processes.
Support governance committees
Develop reports and dashboards and deliver
data-driven recommendations to leadership.
Performs other duties as assigned.
Physical Demands
Weight Lifted:
Up to 20 lbs,
Occasionally 0-30%
of time
Weight Carried:
Up to 20 lbs,
Occasionally 0-30%
of time
Vision:
Moderate, Frequently 31-65% of time
Kneeling/Stooping/Bending:
Occasionally 0-30%
Standing/Walking:
Occasionally 0-30%
Pushing/Pulling:
Occasionally 0-30%
Intensity of Work:
Frequently 31-65%
Job Requires:
Reading, Writing, Reasoning, Talking, Keyboarding, Driving
Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.
NGHS: Opportunities start here.
Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.