Care New England · 23 hours ago
Revenue Integrity Analyst
Warwick, RI
Full-time
Onsite
Mid Level
3+ years expCare New England is seeking a Revenue Integrity Analyst to support accurate charge capture by analyzing clinical, financial, and operational data. The role focuses on proactive analysis, root cause identification, and development of process improvements to optimize revenue capture and reduce leakage.
AssociationHealth Care
Responsibilities
Conduct in-depth analysis of Epic Revenue Guardian reports, charge work queues, and other data sources to identify systemic charge capture issues, trends, and patterns
Reconcile clinical documentation against charges, with emphasis on identifying root causes of discrepancies and developing process improvements
Partner with Revenue Integrity leadership to monitor key performance indicators (KPIs), prepare dashboards, and present findings to management and clinical leaders
Collaborate with all revenue cycle teams to recommend workflow changes that improve documentation accuracy, charge capture, and reimbursement
Contribute to ongoing review and optimization of CDM and charge workflows, ensuring alignment with regulatory and payer guidelines
Assist in the development of Revenue Guardian rules, edits, and reports to improve monitoring and charge capture
Prepare detailed audit support documentation and partner with revenue cycle leaders on internal and external audit responses
Identify and escalate systemic revenue leakage issues, recommending strategies for resolution
Support development of training materials and provide guidance to clinical and operational teams on charge capture best practices
Stay current on regulatory changes, payer policies, and industry best practices, and assess their impact on charge capture workflows
Serve as a subject matter expert for charge integrity initiatives, providing insights and recommendations to leadership
Demonstrate accountability and initiative in advancing organizational goals around revenue optimization, and efficiency
Qualification
Required
High School or GED Required
Minimum 3 to 5 Years experience
Knowledge of CPT, HCPCS, and ICD-10 coding systems and their application to charge capture and reimbursement
Strong understanding of healthcare revenue cycle operations, including facility and professional billing workflows
Familiarity with Medicare, Medicaid, and commercial payer reimbursement methodologies and requirements
Proficiency with Epic (or comparable EHR/EMR systems), with the ability to analyze work queue data, configure Revenue Guardian rules, and develop reports
Working knowledge of the Charge Description Master (CDM) and its impact on pricing, charging, and reimbursement
Demonstrated analytical skills with the ability to extract, interpret, and present complex data sets using Excel and other reporting tools
Preferred
Associate's Degree Preferred
Company
Care New England
Care New England (CNE) is a non-profit health system, comprising several hospitals in Rhode Island, including Butler, Women & Infants
5001-10000 employees
H1B Sponsorship
Care New England has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (3)
2023 (2)
Funding
Current Stage
Late StageLeadership Team
Ana Tuya Fulton
Chief population health officer
Recent News
2025-11-01
Providence Business News
2025-10-22
Boston Globe
2025-08-19
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