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 DoD’s 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 (ICD‑10‑CM, 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 UB‑04 and CMS‑1500 billing accuracy and troubleshoot errors impacting payer acceptance or reimbursement.
Data Analytics & Reporting
Analyze clinical, financial, and operational data to identify trends and develop data‑driven recommendations for revenue improvement.
Use MHS GENESIS/Cerner analytics tools (HealtheAnalytics, HDI) to interpret dashboards and monitor performance metrics.
Prepare executive‑level reporting and visualizations to communicate findings, risks, and remediation strategies.
Cross‑Functional 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 'PUBLIC TRUST'; candidates must obtain approved adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE PUBLIC TRUST or SUITABILITY are preferred.
Bachelors Degree
FOUR (4) or more years of Revenue Cycle Management (RCM) build experience, including troubleshooting, system reconfiguration, and/or project management.
What Would Be Nice To Have:
Bachelor’s Degree in Business, Management, Healthcare Administration, Business Analysis, Statistics, or related field
Proficiency in ICD‑10‑CM, CPT/HCPCS, modifiers, NCCI, and federal billing regulations (TRICARE, DHA).
Understanding of Chargemaster (CDM) structure and charge reconciliation processes.
Experience with MHS GENESIS / Cerner, charge capture, billing workflows, and revenue integrity functions.
Strong skills in denial root cause analysis, remittance interpretation, and claim lifecycle management
Familiarity with claim scrubber tools, billing systems, and payer edit logic.
Strong analytical and critical‑thinking skills with ability to interpret complex data and interpret Excel‑based or system‑generated dashboards.
Effective communication skills with the ability to train, educate, and influence stakeholders.
Understanding of healthcare billing, medical necessity, and revenue cycle operations.
Experience working within the Military Health System (MHS) or other federal health systems.
Background in hospital or professional billing environments.
Certifications such as CPC, CCS, CPMA, or RHIT/RHIA.
Prior consulting experience or participation in large‑scale EHR or revenue cycle implementations
The annual salary range for this position is $80,000.00-$133,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Student Loan PayDown
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Mobility Stipend
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
About the job
Apply for this position
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 DoD’s 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 (ICD‑10‑CM, 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 UB‑04 and CMS‑1500 billing accuracy and troubleshoot errors impacting payer acceptance or reimbursement.
Data Analytics & Reporting
Analyze clinical, financial, and operational data to identify trends and develop data‑driven recommendations for revenue improvement.
Use MHS GENESIS/Cerner analytics tools (HealtheAnalytics, HDI) to interpret dashboards and monitor performance metrics.
Prepare executive‑level reporting and visualizations to communicate findings, risks, and remediation strategies.
Cross‑Functional 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 'PUBLIC TRUST'; candidates must obtain approved adjudication of their PUBLIC TRUST prior to onboarding with Guidehouse. Candidates with an ACTIVE PUBLIC TRUST or SUITABILITY are preferred.
Bachelors Degree
FOUR (4) or more years of Revenue Cycle Management (RCM) build experience, including troubleshooting, system reconfiguration, and/or project management.
What Would Be Nice To Have:
Bachelor’s Degree in Business, Management, Healthcare Administration, Business Analysis, Statistics, or related field
Proficiency in ICD‑10‑CM, CPT/HCPCS, modifiers, NCCI, and federal billing regulations (TRICARE, DHA).
Understanding of Chargemaster (CDM) structure and charge reconciliation processes.
Experience with MHS GENESIS / Cerner, charge capture, billing workflows, and revenue integrity functions.
Strong skills in denial root cause analysis, remittance interpretation, and claim lifecycle management
Familiarity with claim scrubber tools, billing systems, and payer edit logic.
Strong analytical and critical‑thinking skills with ability to interpret complex data and interpret Excel‑based or system‑generated dashboards.
Effective communication skills with the ability to train, educate, and influence stakeholders.
Understanding of healthcare billing, medical necessity, and revenue cycle operations.
Experience working within the Military Health System (MHS) or other federal health systems.
Background in hospital or professional billing environments.
Certifications such as CPC, CCS, CPMA, or RHIT/RHIA.
Prior consulting experience or participation in large‑scale EHR or revenue cycle implementations
The annual salary range for this position is $80,000.00-$133,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Student Loan PayDown
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Mobility Stipend
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.