156 revenue integrity analyst jobs found

Description Responsibilities: Maintains a systematic and fully integrated insurance billing and follow up as established by hospital policies and procedures. Reviews accounts for accuracy of charges prior to billing insurance, identifies sources of error, informs the supervisor, and initiates constructive suggestions to correct the error. Maintains accurate on-line documentation on all insurance filing and patient contact related to concerns, questions, and/or issues on accounts. Answers and initiates telephone inquiries to/from patients and third-party payers as needed; documents activity in account (s). Completes reconciliation of accounts along with completion of refunds to patient and payers as needed. Works with all necessary departments as needed to secure reimbursement for claims. Coordinates with manager for charge additions and corrections. Able to plan work detail and meet schedules consistently and promptly. Demonstrates responsibility for use of...

Job Summary Under the direction of the Associate Director/Revenue Manager, the Medical Billing Coder aka Professional Fee Coder - Revenue Cycle Analyst will be responsible for front-end billing functions from procedural & diagnosis coding and charge entry to contacting physicians for documentation tracking and updating. Working under direct supervision the incumbent acquires knowledge of revenue cycle coding practices and concepts. Developing proficiency to manage 500 - 1000 code combinations to include Evaluation and Management Services as well as simple to moderately complex testing and procedural code services. The Medical Billing Coder will work to acquire and master all entry-level coding functions including assigning appropriate CPT and Dx codes, associated modifiers, appropriate NCCI edits, resolving coding edits and RFIs as well as basic entry-level revenue cycle duties. Other duties may include assisting other Departments as needed/assigned. As a Medical Billing...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

Professional Fee Coder - Analyst II FPO - Revenue Management Full Time 87835BR Job Summary Professional Fee Coder - Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. Analyst II will perform an in-depth review of physician documentation and is responsible to present findings along with recommendations to the department on physician education. The incumbent should be familiar with all applicable billing and coding regulations and be able to effectively communicate these regulations to all levels of faculty, management and staff. This position will also assign codes based on a review of clinical charts, resolve coding issues based on denials, and identify areas of improvement....

Medical Billing Coder - Per Diem 20% Under the direction of the Associate Director/Revenue Manager, the Medical Billing Coder aka Professional Fee Coder - Revenue Cycle Analyst will be responsible for front-end billing functions from procedural & diagnosis coding and charge entry to contacting physicians for documentation tracking and updating. Working under direct supervision the incumbent acquires knowledge of revenue cycle coding practices and concepts. Developing proficiency to manage 500 - 1000 code combinations to include Evaluation and Management Services as well as simple to moderately complex testing and procedural code services. The Medical Billing Coder will work to acquire and master all entry-level coding functions including assigning appropriate CPT and Dx codes, associated modifiers, appropriate NCCI edits, resolving coding edits and RFIs as well as basic entry-level revenue cycle duties. Other duties may include assisting other Departments as needed/assigned....

Professional Fee Coder - Analyst II FPO - Revenue Management Full Time 87835BR Job Summary Professional Fee Coder - Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. Analyst II will perform an in-depth review of physician documentation and is responsible to present findings along with recommendations to the department on physician education. The incumbent should be familiar with all applicable billing and coding regulations and be able to effectively communicate these regulations to all levels of faculty, management and staff. This position will also assign codes based on a review of clinical charts, resolve coding issues based on denials, and Identify areas of...

Revenue Analyst Coder TEP-Health Employees Temporary Employment 87904BR Job Summary Please note: the anticipated duration of this assignment is six months (potential to extend). Involves revenue cycle functions for the healthcare enterprise, including system billing, reporting and support. Ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services. Impacts processes to include charge capture, coding, insurance identification, data entry, billing, payment posting, refund processing and collections. May also be responsible for / integrated with business office operations. Department Description UCSF's Temporary Employment Program (TEP) recruits and hires temporary employees for immediate clerical and technical support services to UCSF Departments and various off-campus locations. UCSF departments deploy temporary employees to work on special projects, fill in for regular employees who are...

Coding Integrity Specialist - Professional Fee Join to apply for the Coding Integrity Specialist - Professional Fee role at Huron. Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long?term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the...

Billing Analyst (Contract-to-Hire) - Plano, TX (Hybrid) We are seeking a detail-oriented and proactive Billing Analyst to join our team on a contract-to-hire basis. This role supports key billing and revenue cycle functions, with a strong focus on analyzing payment trends, identifying payer issues, and driving denial resolution. Ideal candidates bring a quality assurance mindset, strong analytical skills, and hands-on DME billing experience-especially with oxygen-related products. Key Responsibilities Hybrid schedule: On-site 3 days per week in Plano, TX Analyze billing, claims, and payment data to identify trends, irregularities, and denial patterns Investigate root causes of denied/underpaid claims, including policy discrepancies and documentation gaps Recommend and implement corrective actions to prevent future denials and improve collections Collaborate with billing, coding, and reimbursement teams to strengthen process accuracy and compliance Independently...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD-10-CM,...

PRN Coder Analyst IV Marshall Health Network's Health Information Management department is seeking a PRN Coder Analyst IV. System Specific Duties and Responsibilities: Assign accurate diagnosis and procedure codes using ICD-10-CM/PCS, CPT, and/or HCPCS for reimbursement, compliance, and reporting purposes. Utilizes coding guidelines set up by government agencies dealing with the coding of health information. Demonstrates, promotes, and monitors for high standards of quality and productivity; focuses on quality results first. Maintains a standard of productivity that consistently meets or exceeds 98% of productivity. Maintains a standard or quality that consistently meets or exceeds 95% accuracy rate. Proficient to expert level knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code sets. Proficient to expert level knowledge of MS-DRG and APR-DRG groupers and Medicare's inpatient prospective payment system (IPPS) and outpatient prospective payment system...

Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the...

Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the Plans'...

Pro Fee Coder Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder I may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may...

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Revenue Cycle Revenue Integrit Work Type: Full Time (Total FTE between 0.9 and 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $29.36 - $47.79 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: The Billing Coding Auditor uses advanced knowledge of billing, coding, auditing, documentation requirements, and charge capture to solve complex...

Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the...

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding in accordance with CMS, NCCI, and...

Evolent Health Care Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in...