Revenue Integrity Analyst

Scheduled Weekly

Hours:

40 hours per week

Revenue Integrity Analyst – Emplify Health

Responsible for identifying opportunities or problems, process improvements and other system changes to enhance revenue cycle performance. This role will have ongoing interactions with clinical leadership, revenue cycle staff, Finance, and IT teams. The analyst works closely with revenue cycle departments to ensure that clinical departments are informed regarding regulatory changes that affect charging processes and that charge reconciliation is performed accurately.

Major Responsibilities:

• Research and analyze professional (PB) and Facility (HB) claims prior to new clinical services being added to ensure appropriate reimbursement and compliance with payer policies.
• Collaborate with Clinical Operation Directors and leaders to perform charge reconciliation and create mitigation plans for delayed charges.
• Interpret existing revenue cycle policies and recommend improvements.
• Serve as point of contact for complex billing scenarios, establishing proper processes to get claims filed.
• Facilitate multi‑department billing steering committee and oversee Revenue Guardian Edits in Epic.
• Review Epic dashboards to ensure timely capture and compliance of charges.
• Work with Information Systems to rectify claims data transmission issues and track changes.
• Create and maintain ad‑hoc reports to ensure consistency of claim submissions and support charge master updates in Epic.
• Maintain extensive knowledge of current EHR billing software modules and how they relate to payer processes.
• Collaborate with Revenue Cycle leaders to improve billing workflows and claims submission practices.
• Collaborate with Compliance on regulated billing rules and policies to ensure new services are set up appropriately.

What's Available:

• Fulltime, 80 hours biweekly (1.0 FTE)
• Monday‑Friday core business hours
• Remote work options for residents in WI, MN, or IA; occasional onsite support required

An Ideal Candidate Will Have:

• Education: Bachelor’s degree in Business, Healthcare Administration, Finance, or related field preferred; equivalent experience may be considered.
• Experience: Minimum 4 years in healthcare with billing system experience.
• Certifications: AAPC or AHIMA certification preferred.
• Analytical Thinking: Ability to interpret complex data and provide actionable insights.
• Communication: Strong verbal and written skills; comfortable presenting to executive leadership.
• Adaptability: Thrives in a dynamic environment with evolving regulations.
• Problem‑Solving: Proactively identifies issues and develops innovative solutions.
• Attention to Detail: Ensures accuracy in charge capture, compliance, and financial reporting.

Benefits:

• Medical, dental, pet insurance, and substantial retirement contribution
• 24/7 Employee Assistance Program, generous PTO and paid holidays
• Tuition Investment Program up to $3,000 per year, extensive internal courses, corporate incubator, Career Development Center
• 12 months of DEI celebration and monthly educational events

Equal Opportunity Employer