Revenue Integrity Billing and Coding Analyst
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AI Summary
The analyst will resolve claim edits and pre-bill holds within the Epic system to prevent revenue leakage. They are also responsible for auditing clinical documentation for coding accuracy and collaborating with clinical teams to improve workflows.
Benefits:
- Retirement Plan
- Employee Assistance Program
- Long Term Disability
- Life Insurance
- Dental insurance
- Health insurance
- Paid time off
- Training & development
- Vision insurance
- Wellness resources
Community Medical Center is seeking a detail-oriented Revenue Integrity Billing & Coding Analyst to join our revenue cycle team. This position bridges the gap between clinical documentation, coding, and finance. You will analyze medical records, resolve complex claim edits using our Epic EHR system, and prevent revenue leakage while ensuring strict compliance with federal and payer regulations.
While on-site (in-house) work is highly preferred, we will consider flexible hybrid or 100% remote arrangements for the right candidate. Due to state tax and operational requirements, all applicants must currently reside in the state of Nebraska to be considered for the hybrid or remote position.
Core Responsibilities
- Epic Claim Edit Resolution: Analyze and resolve pre-bill holds, CCI edits, and medical necessity errors within the Epic billing system.
- Charge Capture & Auditing: Audit clinical documentation to ensure accurate CPT, HCPCS, and ICD-10 code assignment.
- Denial Management: Identify root causes of claim denials and collaborate with billing teams to implement corrective actions.
- Cross-Functional Collaboration: Partner with clinical departments to provide education on documentation improvements and charging workflows.
Qualifications & Requirements
- Residency: Must be a current resident of Nebraska (Required to be considered for the hybrid or remote position).
- Technical Skills: Proficiency with the Epic EHR platform is desired.
- Experience: Minimum of 3–5 years of experience in healthcare medical billing, coding, and revenue integrity.
- Certifications: Active credential from AAPC (e.g., CPC, COC) or AHIMA (e.g., CCS, RHIA, RHIT) is highly preferred but not required.
- Attributes: Deep understanding of Medicare/Medicaid reimbursement methodologies, strong analytical skills, and ability to work independently and effectively.
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