Revenue Integrity Analyst (Medical Coding)

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 Systems enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis system support and crossfunctional 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 ICD10 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 charttobill 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 :

Bachelors 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 ICD10 ICD10PCS 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 $80000.00-$133000.00. 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 EmployerProtected 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- or via email at . 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 @ or . 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 Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants 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.

Required Experience :

IC

Key Skills

ASC 606,Hotel Experience,Hospitality Experience,GAAP,Accounting,Revenue Management,Pricing,Analysis Skills,Salesforce,SOX,ERP Systems,NetSuite

Employment Type : Full-Time

Experience : years

Vacancy : 1

Monthly Salary Salary : 80000 - 133000