Revenue Integrity Analyst (Medical Biller)
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Job Location:
San Antonio, TX - USA
Monthly Salary:
$ 80000 - 133000
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Family:
Finance & Accounting Consulting
Travel Required:
Clearance Required:
What You Will Do:
Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing coding and revenue cycle expertise to support the modernization of MHS GENESIS the DoDs enterprise EHR. The role ensures accurate billing compliant charge capture and efficient claim resolution by analyzing data auditing documentation and collaborating with clinical coding IT and financial teams across the Military Health System.
Responsibilities of this role are as follows to include but not limited to:
Support and optimize MHS GENESIS revenue cycle configuration including charge capture workflows billing rules and work queues.
Validate charge accuracy coding logic modifiers and payer requirements; troubleshoot system and workflow issues.
Analyze financial clinical and operational data to identify trends charge variances and revenue improvement opportunities.
Investigate claim edits and denials identify root causes and coordinate corrections with clinical and coding teams.
Reconcile clinical activity to billing outputs and improve charge capture and CDM workflows.
Perform charttobill audits to ensure documentation coding (CPT ICD10 HCPCS) and billing compliance.
Educate staff on proper coding documentation and revenue cycle best practices; support multidisciplinary workgroups.
Recommend process and workflow improvements to reduce denials enhance compliance and support systemwide standardization.
What You Will Need:
Must be able to OBTAIN and MAINTAIN a Federal or DoD PUBLIC TRUST; candidates must obtain approved adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE PUBLIC TRUST or SUITABILITY are preferred.
Bachelors Degree
FOUR (4) or more years of Revenue Cycle Management (RCM) build experience including troubleshooting system reconfiguration and/or project management.
What Would Be Nice To Have:
Bachelors Degree in Business Management Healthcare Administration Business Analysis Statistics or related field
Strong working knowledge of CPT ICD10 and HCPCS Level II coding systems.
Understanding of Chargemaster (CDM) structure and charge reconciliation processes.
Experience with EHR systems such as Oracle Health (Cerner) or MHS GENESIS including encounter review and charge workflows.
Familiarity with claim scrubber tools billing systems and payer edit logic.
Strong analytical and criticalthinking skills with ability to interpret complex data.
Effective communication skills with the ability to train educate and influence stakeholders.
Understanding of healthcare billing medical necessity and revenue cycle operations.
Experience working within the Military Health System (MHS) or other federal health systems.
Background in hospital or professional billing environments.
Certifications such as CPC CCS CPMA or RHIT/RHIA.
Prior consulting experience or participation in largescale EHR or revenue cycle implementations
What We Offer:
Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical Rx Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Student Loan PayDown
Tuition Reimbursement Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Mobility Stipend
About Guidehouse
Guidehouse is an Equal Opportunity EmployerProtected Veterans Individuals with Disabilities or any other basis protected by law ordinance or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities or to apply for a position and you require an accommodation please contact Guidehouse Recruiting at 1- or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @ or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse please report the matter to Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Required Experience:
IC
Key Skills
- EMR Systems
- Medical Collection
- Athenahealth
- eClinicalWorks
- ICD-10
- Medical Coding
- Medical office experience
- ICD-9
- Medical Billing
- Medical Terminology
- CPT Coding
- Medicare
About Company
Guidehouse is the only scaled advisory consultancy in the world to fully integrate commercial and public or government businesses within each of our industry segments because complex problems require both perspectives to address and outwit.
