Revenue Integrity Analyst

Sioux Falls, SD - USA

Monthly Salary: $ 25 - 38

Posted on: 2 days ago

Vacancies: 1 Vacancy

Job Summary

Location:

Avera Downtown Building-Sioux Falls

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$25.50 - $38.25

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

The Revenue Integrity Analyst is responsible for enhancing financial performance ensuring accurate charge capture and securing appropriate reimbursement across the revenue cycle. This role combines expertise in analytics charge auditing and payment integrity to support strategic decision-making operational efficiency and compliance. The analyst collaborates with clinical billing coding IT and payer relations teams to identify trends resolve discrepancies and drive continuous improvement across Hospital Billing (HB) and Professional Billing (PB) services.

What you will do

Design maintain and enhance dashboards and scorecards for denials write-offs payer performance and charge activity. Analyze trends and translate complex data into actionable insights for stakeholders.
Conduct audits and Revenue Guardian checks to validate charge accuracy and completeness. Perform payer-specific audits and monitor ED Discharge and Charge Tracker Reports.
Monitor and resolve Discharged Not Billed (DNB) accounts to ensure timely claim submission.
Investigate denials and underpayments identify root causes and recommend process improvements.
Manage appeals for underpaid claims track outcomes and report on recovery efforts and payment trends.
Review high-dollar write-offs for appropriateness and escalate discrepancies as needed.
Oversee Post-Service Single Case Agreements (SCAs) to ensure reimbursement accuracy and adherence to contract terms.
Partner with clinical operational and payer relations teams to resolve discrepancies and improve documentation.
Participate in audits strategic initiatives and projects aimed at financial optimization and revenue integrity.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others hear understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge skills and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions as long as the accommodations do not cause undue hardship to the employer.

Required Education License/Certification or Work Experience:

Associates in Healthcare Administration Finance Business Analytics or related field and/or 2-3 years of experience in healthcare revenue cycle analytics charge auditing or payment integrity.
Two to three years experience in healthcare revenue cycle analytics charge auditing or payment integrity.
Knowledge of healthcare billing denial management and/or payer reimbursement methodologies.

Preferred Education License/Certification or Work Experience:

Bachelors
Certified Revenue Cycle Representative (CRCR) - Healthcare Finance Management Association (HFMA) Upon Hire or
Certified Specialist Payment & Reimbursement (CSPR) - Healthcare Finance Management Association (HFMA) Upon Hire
Proficiency in data visualization tools (e.g. Power BI Tableau) and Excel
Experience with Epic reporting tools (e.g. SlicerDicer Reporting Workbench Clarity billing and contract modules)

Expectations and Standards

Commitment to the daily application of Averas mission vision core values and social principles to serve patients their families and our community.
Promote Averas values of compassion hospitality and stewardship.
Uphold Averas standards of Communication Attitude Responsiveness and Engagement (CARE) with enthusiasm and sincerity.
Maintain confidentiality.
Work effectively in a team environment coordinating work flow with other team members and ensuring a productive and efficient environment.
Comply with safety principles laws regulations and standards associated with but not limited to CMS The Joint Commission DHHS and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced healthy lives. Benefits are designed to meet needs of today and into the future.

PTO available day 1 for eligible hires.
Up to 5% employer matching contribution for retirement
Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability Veteran Status or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application please call 1- or send an email to .

Required Experience:

Location:Avera Downtown Building-Sioux FallsWorker Type:RegularWork Shift:Day Shift (United States of America)Pay Range:The pay range for this position is listed below. Actual pay rate dependent upon experience.$25.50 - $38.25Position HighlightsYou Belong at AveraBe part of a multidisciplinary team ...