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Revenue Integrity Analyst (Medical Coding)

Guidehouse

Full-time
USA
$80k-$133k per year
medical coding
analyst
medical
documentation
statistics
The job listing has expired. Unfortunately, the hiring company is no longer accepting new applications.

To see similar active jobs please follow this link: Remote Healthcare jobs

Job Family:

Finance & Accounting Consulting

Travel Required:

Up to 25%

Clearance Required:

Ability to Obtain Public Trust

What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System’s enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross‑functional collaboration.

Responsibilities of this role are as follows, to include but not limited to:

  • System Configuration & Support: Validate and troubleshoot MHS GENESIS revenue cycle build, including coding workflows, charge capture, charge router logic, and billing integrations. Ensure accurate mapping of CPT, ICD‑10, HCPCS, modifiers, and charge codes.

  • Data Analysis: Analyze clinical and financial data to identify coding variances, charge gaps, and revenue integrity issues. Produce reports, track KPIs, and recommend solutions.

  • Claim & Denial Management: Investigate edits, rejections, and denials; identify root causes; and coordinate fixes with coding, clinical, revenue cycle, and IT teams.

  • Charge Capture Optimization: Reconcile clinical activity against charges, validate CDM mapping, and ensure charges flow correctly across departments.

  • Auditing & Compliance: Conduct chart‑to‑bill audits, confirm coding accuracy, and ensure alignment with DHA, CMS, and federal regulations.

  • Training & Collaboration: Educate clinicians and RCM staff, serve as liaison between operational and build teams, and support revenue improvement workgroups.

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

  • Experience with Oracle/Cerner EHR RCM Solution initial builds, trouble shooting, issue resolution, and system reconfigurations.

  • Proficiency in CPT, ICD‑10, ICD‑10‑PCS, and HCPCS coding systems.

  • Experience performing clinical coding audits, charge capture reviews, or revenue integrity analysis.

  • Familiarity with MHS GENESIS, Oracle Health, or similar EHR revenue cycle modules (charge router, encounter coding, professional/hospital billing).

  • Understanding of CDM structure, charge routing logic, and billing edits.

  • Strong analytical skills with the ability to interpret clinical documentation and financial data.

  • Excellent communication skills, with the ability to explain coding and documentation concepts to clinical and administrative stakeholders.

  • Experience working within the Military Health System (MHS) or other federal health systems.

  • Knowledge of DHA billing policies, TRICARE requirements, and federal reimbursement guidelines.

  • Coding certifications such as CPC, CCS, CPMA, RHIT, or RHIA.

  • Experience supporting EHR configuration, workflow design, or revenue cycle modernization initiatives.

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

Full-time
USA
Mid Level
$80k-$133k per year
Posted 1 month ago
medical coding
analyst
medical
documentation
statistics
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Revenue Integrity Analyst (Medical Coding)

Guidehouse
The job listing has expired. Unfortunately, the hiring company is no longer accepting new applications.

To see similar active jobs please follow this link: Remote Healthcare jobs

Job Family:

Finance & Accounting Consulting

Travel Required:

Up to 25%

Clearance Required:

Ability to Obtain Public Trust

What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System’s enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross‑functional collaboration.

Responsibilities of this role are as follows, to include but not limited to:

  • System Configuration & Support: Validate and troubleshoot MHS GENESIS revenue cycle build, including coding workflows, charge capture, charge router logic, and billing integrations. Ensure accurate mapping of CPT, ICD‑10, HCPCS, modifiers, and charge codes.

  • Data Analysis: Analyze clinical and financial data to identify coding variances, charge gaps, and revenue integrity issues. Produce reports, track KPIs, and recommend solutions.

  • Claim & Denial Management: Investigate edits, rejections, and denials; identify root causes; and coordinate fixes with coding, clinical, revenue cycle, and IT teams.

  • Charge Capture Optimization: Reconcile clinical activity against charges, validate CDM mapping, and ensure charges flow correctly across departments.

  • Auditing & Compliance: Conduct chart‑to‑bill audits, confirm coding accuracy, and ensure alignment with DHA, CMS, and federal regulations.

  • Training & Collaboration: Educate clinicians and RCM staff, serve as liaison between operational and build teams, and support revenue improvement workgroups.

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

  • Experience with Oracle/Cerner EHR RCM Solution initial builds, trouble shooting, issue resolution, and system reconfigurations.

  • Proficiency in CPT, ICD‑10, ICD‑10‑PCS, and HCPCS coding systems.

  • Experience performing clinical coding audits, charge capture reviews, or revenue integrity analysis.

  • Familiarity with MHS GENESIS, Oracle Health, or similar EHR revenue cycle modules (charge router, encounter coding, professional/hospital billing).

  • Understanding of CDM structure, charge routing logic, and billing edits.

  • Strong analytical skills with the ability to interpret clinical documentation and financial data.

  • Excellent communication skills, with the ability to explain coding and documentation concepts to clinical and administrative stakeholders.

  • Experience working within the Military Health System (MHS) or other federal health systems.

  • Knowledge of DHA billing policies, TRICARE requirements, and federal reimbursement guidelines.

  • Coding certifications such as CPC, CCS, CPMA, RHIT, or RHIA.

  • Experience supporting EHR configuration, workflow design, or revenue cycle modernization initiatives.

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.

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