Revenue Integrity Analyst

GENERAL SUMMARY:
We are new but mighty. Xtensys, a recently established managed service provider, delivering cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We seek a skilled Revenue Integrity Analyst to join our team of 500 and support our exciting journey. We value people and are building a culture to match. 

Job Summary: 
The Revenue Integrity Analyst is responsible for ensuring accurate, compliant, and efficient charge capture and billing practices and revenue optimization for both professional and hospital services. This position supports revenue integrity through charge audits, workflow analysis, payer compliance monitoring, and collaboration with operational, clinical, and coding teams. The ideal candidate has a strong understanding of Epic systems, coding standards, and billing regulations across both the physician and facility revenue streams.

Job Responsibilities Include:
•    Monitor missed charges, charge lags, and duplicate entries using Epic work queues and charge review tools.
•    Perform routine and targeted audits of charge capture for both professional and hospital services to ensure accuracy and compliance with CMS, Medicaid, and commercial payer rules.
•    Serve as a resource to providers, coding, and clinical departments for professional and hospital charge capture questions,
•    Use Epic reporting tools (e.g., SlicerDicer, Reporting Workbench,) to extract and analyze charge data.
•    Collaborate with clinical departments, coding teams, and billing staff to resolve charge capture or coding issues.
•    Review daily charge reports and audit encounters to validate proper charge capture for inpatient, outpatient, and ancillary services.
•    Participate in hospital-wide initiatives such as CDM reviews, service line pricing reviews, and new procedure implementation
•    Collaborate with clinical departments (e.g., Radiology, Surgery, Pharmacy) to review workflows and ensure accurate charge capture and revenue recognition.
•    Prepare reports and present findings to stakeholders and leadership.
•    Other duties and projects as assigned.

Requirements:
•    Education: Associates’ Degree. CPC, RHIA, or RHIT preferred
•    Experience:
         o    3+ years’ experience in a healthcare setting
     o    In lieu of a Associates’ degree, the following may be considered:
             a High School Diploma or GED with 5 years of billing experience in a healthcare environment  
•    Skills: Strong leadership abilities, analytical skills, proficient in Excel, interpersonal skills, strong customer service skills and excellent oral/written communication skills.
•    Knowledge: Strong understanding of healthcare billing processes, insurance regulations, and compliance standards. Maintain current knowledge of applicable coding, billing, and compliance regulations (e.g., CPT, HCPCS, ICD-10, CMS guidelines).
•    Epic Experience: Required.
•    Physical Requirements: Ability to lift up to 20 pounds, sit or stand for extended periods, and perform repetitive hand and finger motions.