Analyst

• Ensure accurate revenue capture, payer compliance, and optimized reimbursement for the health system
• Investigate and analyze high-impact billing edits, recurring revenue discrepancies, and coding/documentation risks
• Identify trends, root causes, and corrective actions
• Lead in-depth charge capture reviews and collaborate with departments to improve documentation, charging practices, and revenue accuracy
• Develop, analyze, and present dashboards and reports on denial trends, charge lag, missed charges, net revenue performance, and other key revenue metrics
• Perform cost-benefit analyses for revenue improvement proposals, workflow redesigns, and operational strategies
• Participate in payer and internal audits; prepare documentation, support responses, and assist in corrective action planning
• Partner with Compliance and CDM teams to monitor risks, implement billing corrections, and support enterprise-wide initiatives
• Serve as designated analyst for assigned high-volume or complex clinical service lines
• Lead quarterly reviews with operational leaders, presenting findings, trends, risks, and improvement opportunities

Revenue Integrity Analyst II – Facility Support

• Implement, configure, and maintain Epic and other clinical applications, including EHRs, clinical decision support systems, and other clinical software
• Collaborate with clinical end-users, IT staff, and vendors to improve clinical workflows and processes using technology
• Participate in system testing and validation to ensure applications meet regulatory requirements and user needs
• Maintain accurate documentation of system configurations, changes, and troubleshooting procedures
• Participate in testing and validation for Epic software upgrades and enhancements
• Monitor and troubleshoot clinical application issues and provide timely resolution
• Stay current with solutions in the Epic system and other clinical applications
• Collaborate with operational and medical staff leaders on strategic initiatives
• Participate in all phases of the system development life cycle, including use-case development and software-solution evaluation
• Participate in rounding with clinical and business end users

EPIC Applications Analyst II – Cadence and Referrals

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines and Epic workflows
• Develop advanced dashboards and predictive analytics models for denial trends, charge lag, missed charges, and net revenue opportunities
• Perform complex cost-benefit analyses and financial modeling for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support payment policy or denial escalations
• Collaborate with Compliance, Legal, and CDM teams on governance structures, billing corrections, and regulatory requirements
• Serve as senior analyst for high-volume or high-risk service lines
• Lead reviews with operational executives and present findings and recommendations
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

Revenue Integrity Analyst III

• Ensure accurate revenue capture, payer compliance, and optimized reimbursement for the health system
• Investigate and resolve high-impact billing edits, recurring discrepancies, and specialty-specific coding risks
• Analyze revenue trends, root causes, and corrective actions
• Lead in-depth charge capture reviews and improve documentation, charging practices, and revenue accuracy
• Develop, analyze, and present dashboards and reports on denial trends, charge lag, missed charges, net revenue performance, and other revenue metrics
• Perform cost-benefit analyses for revenue improvement proposals, workflow redesign, and operational strategies
• Participate in payer and internal audits; prepare documentation, support responses, and assist with corrective action planning
• Partner with Compliance and CDM teams to monitor risks, implement billing corrections, and support enterprise-wide initiatives
• Serve as the designated analyst for assigned high-volume or complex clinical service lines
• Lead quarterly reviews with operational leaders, presenting findings, trends, risks, and improvement opportunities

Revenue Integrity Analyst II

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines
• Develop advanced dashboards and predictive analytics models tracking denial trends, charge lag, missed charges, and net revenue opportunities
• Perform complex cost-benefit analyses for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support payment policy or denial escalations
• Establish governance structures and implement billing corrections with Compliance, Legal, and CDM teams
• Serve as senior analyst for high-volume or high-risk service lines
• Lead quarterly and ad-hoc reviews with operational executives
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

Revenue Integrity Analyst, III

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines and Epic workflows
• Develop advanced dashboards and predictive analytics models for denial trends, charge lag, missed charges, and net revenue opportunities
• Perform cost-benefit analyses for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support payment policy or denial escalations
• Collaborate with Compliance, Legal, and CDM teams on governance structures, billing corrections, and regulatory requirements
• Serve as senior analyst for multiple high-volume or high-risk service lines
• Lead quarterly and ad-hoc reviews with operational executives
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

• Ensure accurate revenue capture, payer compliance, and optimized reimbursement for the health system
• Investigate and analyze high-impact billing edits, recurring revenue discrepancies, and coding/documentation risks
• Identify trends, root causes, and corrective actions
• Lead in-depth charge capture reviews and implement improvements in documentation, charging practices, and revenue accuracy
• Develop, analyze, and present dashboards and reports on denial trends, charge lag, missed charges, net revenue performance, and other revenue metrics
• Perform cost-benefit analyses for revenue improvement proposals, workflow redesigns, and operational strategies
• Participate in payer and internal audits; prepare documentation, support responses, and assist with corrective action planning
• Partner with Compliance and CDM teams to monitor risks, implement billing corrections, and support enterprise-wide initiatives
• Serve as the designated analyst for assigned high-volume or complex clinical service lines
• Lead quarterly reviews with operational leaders, presenting findings, trends, risks, and improvement opportunities
• Collaborate with clinical, operational, and compliance stakeholders to strengthen documentation and charge capture processes, reduce denials, and improve net revenue realization

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks
• Design and oversee charge capture improvement projects across multiple service lines
• Develop advanced dashboards and predictive analytics models for denial trends, charge lag, missed charges, and net revenue opportunities
• Perform complex cost-benefit analyses and financial modeling
• Lead payer and internal audits and support payment policy or denial escalations
• Collaborate with Compliance, Legal, and CDM teams on governance, billing corrections, and regulatory requirements
• Serve as senior analyst for multiple high-volume or high-risk service lines
• Lead quarterly and ad-hoc reviews with operational executives
• Mentor Analysts I and II and provide technical guidance, coaching, and quality assurance

• Serve as a senior subject matter expert in revenue integrity
• Provide advanced analysis and payer escalation support for complex revenue cycle issues
• Lead high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts
• Investigate systemic billing edits, high-dollar revenue discrepancies, and specialty-specific coding risks; develop corrective-action recommendations
• Design and oversee charge capture improvement projects across multiple service lines and Epic workflows
• Develop dashboards and predictive analytics models monitoring denial trends, charge lag, missed charges, and net revenue opportunities
• Perform cost-benefit analyses for revenue improvement proposals, payer policy changes, and operational redesigns
• Lead payer and internal audits and support escalations of payment policy or denial issues
• Collaborate with Compliance, Legal, and CDM teams on governance, billing corrections, and regulatory requirements
• Serve as senior analyst for high-volume or high-risk service lines
• Lead reviews with operational executives and present findings and recommendations
• Mentor Analysts I and II through technical guidance, coaching, and quality assurance

• Develop proactive and reactive leads to identify potential fraud, waste, and abuse
• Generate FWA leads by mining claims databases, reporting tools, and investigative systems
• Validate and refine business-rule-generated leads for credibility and investigative value
• Examine spike analyses, utilization trends, payment anomalies, and outlier reports
• Evaluate provider, member, pharmacy, DME, transportation, and facility billing for fraud or abuse indicators
• Monitor internal and external intelligence sources for emerging fraud schemes and patterns
• Perform quantitative and qualitative analysis of medical and pharmacy claims data
• Analyze CPT, HCPCS, ICD, DRG, NDC, modifier usage, and reimbursement trends
• Review provider billing history, peer comparisons, utilization metrics, and financial impact analyses
• Research internal systems, public records, licensing boards, sanctions lists, and other investigative resources
• Analyze relationships among providers, members, facilities, and associated entities for potential schemes or collusion
• Develop lead summaries outlining allegations, evidence, and risk indicators
• Present findings and recommendations to SIU leadership and investigative staff
• Determine whether findings warrant formal investigation, monitoring, or closure
• Document investigative rationale and evidence according to SIU policies and regulatory requirements
• Partner with investigators, clinicians, legal, compliance, and business partners
• Participate in fraud trend discussions and special projects
• Support improvements to business rules, data mining strategies, and lead generation methodologies
• Assist with training and knowledge related to emerging fraud schemes and healthcare billing practices
• Ensure compliance with CMS, state Medicaid regulations, Medicare requirements, organizational policies, and SIU procedures
• Maintain confidentiality and safeguard sensitive information
• Meet productivity, quality, and timeliness standards
• Support internal audits, quality reviews, and regulatory reporting activities

Analyst jobs in Oklahoma

Revenue Integrity Analyst II – Facility Support

EPIC Applications Analyst II – Cadence and Referrals

Revenue Integrity Analyst III

Revenue Integrity Analyst II

Revenue Integrity Analyst, III

Revenue Integrity Analyst III

Revenue Integrity Analyst II

Revenue Integrity Analyst III

Revenue Integrity Analyst III

Lead Review Analyst, Special Investigation Unit