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Revenue Integrity Analyst, CDM
Duke University Health SystemCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Revenue Cycle Management, including charge capture, coding compliance, and reimbursement analysis. Proficient in developing educational strategies and conducting quality audits to enhance documentation integrity and optimize revenue.
Highest-signal resume keywords
Coding Certification (CPC, CCS, RHIA, RHIT)Revenue Cycle ExperienceIn-Depth Knowledge Of Medicare/Medicaid RegulationsCharge Capture And Reporting ExperienceStrong Oral And Written Communication Skills
About the role
Key responsibilities & impact- Review pre-bill accounts flagged through Epic Revenue Guardian edits
- Enter missing hospital charges based on supporting medical documentation
- Evaluate charge capture opportunities and determine appropriate charge corrections
- Develop strategies for implementing new Revenue Guardian edits to reduce revenue leakage
- Provide analytical support related to third-party payer reimbursement and contract compliance
- Conduct quality control audits to ensure data/documentation integrity
- Trend accounts qualifying for Revenue Guardian edits and compile data by clinical department for education deliverables
- Serve as Subject Matter Expert to leadership on Revenue Integrity issues
- Prepare monthly reports and educational presentations for clinical departments and Revenue Manager teams
- Monitor data trends to validate documentation improvement initiatives and optimize charge capture
- Follow up with health team members to ensure accurate and complete medical-record documentation
- Collaborate with operational leaders to develop provider and service-line education strategies
- Use root cause analysis to correct negative trends and behaviors
- Review charges and payments for accuracy from contracted payers
- Manage the appeals process with assigned payers in hospital and clinic settings
- Identify revenue gains through reporting tools
- Perform other related duties
Requirements
What you’ll need- Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related degree
- 3 years of experience related to coding required
- Coding certification (e.g. CPC, CCS, RHIA, RHIT) required
- In-depth knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements
- Revenue Cycle experience
- Strong oral and written communication skills
- Research-oriented with ability to critically analyze and reason large amounts of data
- Charge capture, reporting, and analysis experience preferred
Benefits
Comp & perks- Equal Opportunity Employer
- Reasonable accommodation information and support for essential physical job functions
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Charge CaptureData AnalysisQuality Control AuditsRoot Cause AnalysisRevenue Guardian Edits ImplementationContract Compliance EvaluationThird-Party Payer ReimbursementData Trend MonitoringMedical Documentation ReviewEducational Presentation Preparation
Soft Skills
Research-OrientedCritical ThinkingCollaborationCommunication
Tools & Technologies
Epic Revenue Guardian
Certifications & Qualifications
CPCCCSRHIARHIT
Industry Keywords
Revenue IntegrityHealthcare AdministrationBillingCodingDocumentation Requirements