Revenue Integrity Analyst (Medical Biller)

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust 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 DoDu2019s 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: Revenue Integrity & Charge Capture + Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. + Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and revenue leakage. + Audit documentation and coding (ICDu201110u2011CM, CPT/HCPCS, modifiers) to ensure NCCI, LCD/NCD, TRICARE, and DHA compliance. Billing, Claims, & Denial Management + Investigate claim edits and denials using Alpha II, SSI, or related tools; identify root causes and implement sustainable solutions. + Perform payer remittance analysis to uncover denial trends, modifier issues, bundling errors, and reimbursement gaps. + Support UBu201104 and CMSu20111500 billing accuracy and troubleshoot errors impacting payer acceptance or reimbursement. Data Analytics & Reporting + Analyze clinical, financial, and operational data to identify trends and develop datau2011driven recommendations for revenue improvement. + Use MHS GENESIS/Cerner analytics tools (HealtheAnalytics, HDI) to interpret dashboards and monitor performance metrics. + Prepare executiveu2011level reporting and visualizations to communicate findings, risks, and remediation strategies. Crossu2011Functional Collaboration + Partner with coding teams, clinicians, IT analysts, billing offices, and leadership to resolve issues and ensure standardized workflows. + Participate in or lead enterprise-level remediation planning, including root cause analysis, corrective action tracking, and workflow optimization. + Provide staff education on coding, documentation requirements, and revenue cycle best practices. Process Improvement + Recommend and implement workflow improvements to reduce denials, increase first-pass payment rates, and enhance compliance. + Identify and escalate systemic issues affecting charge capture, coding, billing, or payer processing. What You Will Need : + Must be able to OBTAIN and MAINTAIN a Federal or DoD

Created: 2026-03-13