Revenue Integrity Analyst

• Location: Hybrid (Preferred location Milwaukee, Wisconsin)
• Department: Revenue Cycle Administration
• Schedule: Days | Full-Time

#LI-Remote

#InternalOps

• Evaluate patient-care workflows from clinical service delivery through documentation, analyzing charge capture, billing data, denials, and KPIs to identify workflow gaps, root causes, and revenue leakage.
• Partner with clinical, operational, and CDM teams to develop, validate, and maintain Charge Description Master (CDM) structures, CPT/HCPCS/revenue codes, and charge-capture workflows for existing services and new clinical initiatives.
• Direct multi-system revenue integrity operations across Epic and Oracle Health/Cerner applications, utilizing reporting tools and analytics platforms (Excel, Power BI, Tableau) to monitor performance and reimbursement impact.
• Translate CMS and regulatory changes into compliant charging protocols while managing revenue integrity projects, delivering targeted education, and implementing sustainable corrective action plans for clinical leadership.

Education:

• High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Information:

• Heavy clinical background (RN or active clinical licensure) with demonstrated mastery in interpreting complex patient records, physician documentation, and clinical workflows to ensure charge-capture precision.
• Advanced system expertise and/or certifications in Epic or Oracle Health/Cerner EHR environments, paired with credentialing in HIM, coding, or revenue integrity (e.g., RHIA, CCS, CPC, CRCR, or CHRI).