[Hiring] Revenue Integrity Analyst @Avera Health

Role Description

The Revenue Integrity Analyst is responsible for enhancing financial performance, ensuring accurate charge capture, and securing appropriate reimbursement across the revenue cycle. This role combines expertise in analytics, charge auditing, and payment integrity to support strategic decision-making, operational efficiency, and compliance. The analyst collaborates with clinical, billing, coding, IT, and payer relations teams to identify trends, resolve discrepancies, and drive continuous improvement across Hospital Billing (HB) and Professional Billing (PB) services.

• Design, maintain, and enhance dashboards and scorecards for denials, write-offs, payer performance, and charge activity.
• Analyze trends and translate complex data into actionable insights for stakeholders.
• Conduct audits and Revenue Guardian checks to validate charge accuracy and completeness.
• Perform payer-specific audits and monitor ED Discharge and Charge Tracker Reports.
• Monitor and resolve Discharged Not Billed (DNB) accounts to ensure timely claim submission.
• Investigate denials and underpayments, identify root causes, and recommend process improvements.
• Manage appeals for underpaid claims, track outcomes, and report on recovery efforts and payment trends.
• Review high-dollar write-offs for appropriateness and escalate discrepancies as needed.
• Oversee Post-Service Single Case Agreements (SCAs) to ensure reimbursement accuracy and adherence to contract terms.
• Partner with clinical, operational, and payer relations teams to resolve discrepancies and improve documentation.
• Participate in audits, strategic initiatives, and projects aimed at financial optimization and revenue integrity.

Qualifications

• Associate's in Healthcare Administration, Finance, Business Analytics, or related field and/or 2-3 years of experience in healthcare revenue cycle analytics, charge auditing, or payment integrity.
• Two to three years experience in healthcare revenue cycle analytics, charge auditing, or payment integrity.
• Knowledge of healthcare billing, denial management, and/or payer reimbursement methodologies.

Requirements

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits

• PTO available day 1 for eligible hires.
• Up to 5% employer matching contribution for retirement.
• Career development guided by hands-on training and mentorship.