Revenue Integrity Analyst (Medical Coding)

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health Systemu2019s enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and crossu2011functional collaboration. Responsibilities of this role are as follows, to include but not limited to: System Configuration & Workflow Validation + Validate, test, and troubleshoot MHS GENESIS / Cerner coding workflows, including charge capture pathways, coding forms, charge router logic, and billing system integrations. + Ensure accurate mapping and configuration of ICDu201110u2011CM, CPT/HCPCS, modifiers, clinical documentation, and charge codes across departments. + Utilize HealtheAnalytics / HDI and related tools to identify system defects, data inconsistencies, and workflow gaps. + Support enterpriseu2011level remediation planning, translating findings into actionable build or workflow corrections. Data Analysis & Revenue Integrity Monitoring + Analyze clinical, financial, and revenue cycle data to identify coding variances, missing or incorrect charges, and potential revenue leakage. + Conduct DNFB risk analysis, charge variance assessments, and trend monitoring across MTFs. + Produce reports, interpret dashboards, and communicate revenue integrity insights to leadership, coding teams, and RCM partners. + Apply advanced Excelu2011based analysis to identify patterns and support datau2011driven decisionu2011making. Claim Edit & Denial Root Cause Analysis + Investigate claim edits, rejections, and denials using tools such as Alpha II / SSI. + Perform denial root cause analysis, identifying coding errors, modifier issues, NCCI conflicts, payer policy conflicts, and system configuration defects. + Coordinate corrective action with coding, clinical, billing, and IT teams to prevent recurrence. + Conduct payer remittance analysis to ensure accurate adjudication and detect reimbursement discrepancies. Charge Capture Optimization + Reconcile documentation and clinical activity to ensure charges populate correctly through the encounter, coding, and billing workflow. + Validate CDM accuracy, including revenue code mapping, service line alignment, and correct charge routing. + Identify departmentu2011specific charge capture risks and recommend workflow corrections to eliminate leakage. Auditing & Compliance Oversight + Perform chartu2011tou2011bill audits to validate documentation quality, coding accuracy, modifier strategy, and billing completeness. + Ensure compliance with NCCI edits, LCD/NCD guidance, TRICARE policy, and DHA billing requirements. + Monitor adherence to federal and organizational standards for coding and billing integrity. Training, Collaboration & Crossu2011Functional Issue Resolution + Educate clinicians, coders, revenue cycle teams, and operational leaders on documentation expectations, coding rules, and revenue integrity best practices. + Serve as a liaison between clinical operations, RCM, and IT build teams to facilitate accurate issue identification and resolution. + Support or lead multidisciplinary workgroups focused on improving documentation, coding accuracy, claim acceptance, and revenue outcomes. + Process Improvement & Standardization + Recommend enhancements to documentation practices, coding workflows, and charge capture processes to reduce errors and improve financial performance. + Identify opportunities for systemu2011wide standardization, workflow redesign, and improved reporting visibility. + Support enterprise initiatives to improve audit readiness, reduce denials, and strengthen integrated revenue cycle performance. What You Will Need : + Must be able to OBTAIN and MAINTAIN a Federal or DoD

Created: 2026-03-13