[Hiring] Revenue Cycle Compliance Analyst @Altru Health System

Role Description

The Revenue Cycle Compliance Analyst is responsible for monitoring and auditing revenue cycle operations to ensure compliance with federal and state regulations, payer requirements, and organizational policies. This role supports billing integrity, regulatory compliance, and revenue optimization through data analysis, auditing, and collaboration with operational departments. The analyst also assists with initiatives related to price transparency, documentation compliance, denial prevention, and revenue integrity improvements.

• Monitors revenue cycle processes to ensure compliance with CMS, Medicare, Medicaid, and commercial payer regulations.
• Supports the annual external audit and performs periodic ongoing audits of billing, charging, coding, and documentation practices to identify compliance risks and potential revenue leakage.
• Reviews service line billing workflows for adherence to regulatory and organizational policies.
• Analyzes claim denials, RTPs, and payer edits to identify trends and recommend corrective actions.
• Assists with compliance related to Price Transparency, Good Faith Estimates, and No Surprises Act requirements.
• Collaborates with coding, billing, HIM, finance, and clinical departments to resolve billing compliance issues.
• Interprets and researches regulatory updates, payer guidelines, and reimbursement changes impacting revenue cycle operations.
• Prepares audit findings, compliance reports, and recommendations for leadership and operational teams.
• Supports education and training efforts for staff related to billing compliance, documentation standards, and regulatory requirements.
• Performs other duties as assigned or needed to meet the needs of the department/organization.

Qualifications

• Preferred: Bachelors - Related Field

Requirements

• Required: A minimum of 5 years Related Experience
• This position requires proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.

Physical Demands

• Sit: Frequently (34-66%)
• Stand: Occasionally (5-33%)
• Walk: Occasionally (5-33%)
• Stoop/Bend: Rarely (1-4%)
• Reach: Frequently (34-66%)
• Crawl: Not Applicable
• Squat/Crouch/Kneel: Rarely (1-4%)
• Twist: Occasionally (5-33%)
• Handle/Finger/Feel: Continuously (67-100%)
• See: Continuously (67-100%)
• Hear: Continuously (67-100%)

Weight Demands

• Lift - Floor to Waist Level: Sedentary (<10 pounds)
• Carry: Sedentary (<10 pounds)
• Push/Pull: Sedentary (<10 pounds)
• Slide/Transfer: Not Applicable

Working Conditions

• Indoor: Continuously (67-100%)
• Outdoor: Not Applicable
• Extreme Temperature: Not Applicable

Driving Requirement for this position

• Infrequent Driver

Benefits

• Comprehensive benefits package for full- and part-time employees.
• Health plan and 401(k) retirement plan.
• Dental plan.
• Vision plan.
• Life and disability insurance.
• Education assistance.
• Paid time off (PTO).