[Hiring] Revenue Integrity Analyst @Omega Healthcare Solutions

Role Description

Under general supervision, the Revenue Integrity Specialist is the operating muscle of the charge capture engine. Day to day, this individual:

• Reviews charge tickets (both paper scanned and electronic feeds from EHR) against clinical documentation.
• Applies Omega charge capture guidelines to validate or correct the charge.
• Reconciles charges to encounters and surfaces missed charges.
• Supports the dashboarding effort by feeding clean, categorized exception data upstream.
• Works across hospital and physician charging contexts with a working understanding of CPT, HCPCS, ICD-10-CM, modifiers, revenue codes, and place of service implications.

Qualifications

• 3+ years hands-on US revenue integrity, charge capture, or charge audit experience in a US healthcare provider or vendor environment.
• Bachelor’s degree or combination of relevant experience with strong RCM tenure.
• Hands-on proficiency with at least one major EHR platform: EPIC (Resolute HB/PB), Cerner Patient Accounting, Meditech (Magic/Expanse), or Athena.
• Must fulfill one of the following qualifications:
  • Pathway A – Active AAPC (CPC/COC) or AHIMA (CCS/CCS-P) certification.
  • Pathway B – HFMA CRCR certification paired with at least 4 years of demonstrable depth in charge-capture, chargemaster, or charge-router operations.
• Working knowledge of payer guidelines and contracts, including experience in contract review, negotiations, or audit variance review across multiple payers.
• Intermediate Excel proficiency, including pivot tables, lookups, conditional formatting, and basic formulas.

Requirements

• Review paper charge tickets, electronic charge tickets (e-superbills), and EHR-driven charge feeds for completeness, accuracy, and adherence to charge capture guidelines.
• Maintain a clear, auditable documentation trail in the workflow tool, drafting exception notes to defend NCCI (PTP/MUE) and OCE modifier decisions for external auditor review.
• Validate CPT / HCPCS code selection against documentation; verify modifier appropriateness.
• Flag missing or mis-applied units, incorrect revenue codes, place-of-service mismatches, and date-of-service inconsistencies.
• Reconcile daily charge files against scheduled / completed encounters from EHR (Epic / Cerner / Meditech).
• Investigate variances within agreed turnaround time; raise tickets for system-level issues.
• Apply CMS, NCCI, and client specific charge capture guidelines.
• Identify systemic charge capture defects and escalate root cause to Lead with sample evidence.
• Categorize exceptions, denials-prevention findings, and missed charge recoveries using the standard taxonomy.
• Produce daily / weekly individual productivity and accuracy reports; participate in calibration sessions led by QA.
• Operate within HIPAA, HITRUST, and Omega information security policy.
• Cooperate with internal QA audits and respond to audit feedback with documented corrective action.

Benefits

• Comprehensive benefits package that may include health, dental, and vision coverage.
• Voluntary insurance options.
• 401(k) plan with employer match.
• Professional development opportunities.
• Paid time off and holiday pay.
• Opportunity to participate in bonus programs, commissions, or other variable incentive plans.