Revenue Integrity Analyst (Hybrid)

Job Requisition #: JR70474

End Date: 12/11/2023

Location: Wilmington, Delaware

Position Type: Professional

Shift: Day Shift, No Rotation

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Are you a certified Revenue Integrity Analyst looking to join a company based on excellence and love?

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

ChristianaCare Offers

  • Full Medical, Dental, Vision, Life Insurance, etc.
  • Two retirement planning offerings, including 403(b) with company contributions
  • Generous paid time off with annual roll-over and opportunities to cash out
  • 12-week paid parental leave
  • Incredible Work/Life benefits including annual membership to, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

About This Position

ChristianaCare is searching for a Revenue Integrity Analyst to ensure all items and services such as procedures, patient visits, supplies, and pharmaceuticals that are charged for through the Charge Description Master (CDM) are described, coded, and priced appropriately and are representative of services provided. This position will also complete financial analyses of assigned cases to determine charge and revenue implications related to CDM maintenance.

Some responsibilities include:

  • Maintains knowledge of and organizational compliance with state, federal, and other third-party payer billing and reimbursement guidelines.
  • Reviews, develops, implements, evaluates, and revises charge guidelines to ensure compliant charging; effectively implements recommendations and monitors results.
  • Compiles and analyzes data from various sources to develop recommendations leading to potential revenue cycle opportunities, including analyses related to CDM set-up, charge capture, billing and/or patient financial services.
  • Facilitates mitigation of edits to ensure appropriate coding and claim submission to secure reimbursement by distributing edits to appropriate departmental queues.
  • Tracks edit volume by type and department for management purposes. Prepares weekly status reports of accounts and dollars pending due to bill edits.
  • Provides feedback to coding, access, ancillary services, clinic, surgical, and patient financial management staff. Manages edits by error type.
  • Collaborates with departments on developing process changes to reduce pre-bill edits and achieve clean claims.
  • Researches and resolves claim pre-bill edits and pre-bill errors within the assigned queue, including review and correction of the daily assigned DNFB hold code claims that fail for NCCI/MUE edits and third-party payer medical necessity LCD/NCD edits in the billing editor. Applies LCD and NCD (local and national coverage determination) rules.
  • Provides reimbursement education to coders and others regarding billing requirements for outpatient coding data to prevent future occurrences of the billing edit.
  • Acts as a coding reimbursement resource and assists in root-cause analyses.
  • Participates in special projects to facilitate revenue management as required for new facilities/acquisitions, new departments, new service lines, changes in regulations, etc.
  • Develop and maintain tracking reports.

Requirements Include.....

  • Bachelor's degree from an accredited college in a relevant field of study.
  • One to three years of revenue cycle management and/or revenue integrity experience in a healthcare environment.
  • 3-5 years experience in Charge Description Master (CDM) is highly desired. Equivalent and relevant combination of education and experience may be considered in lieu of Bachelor's degree.

Certification: A Coding Certification (CPC, COC, CCS) is required or certification must be obtained within 1-2 years of employment.

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Why do WE offer careers full of possibilities?

For the Love of Health.

Inclusion & Diversity

At ChristianaCare, we’re committed to treating everyone with dignity and respect. We believe in a safe, inclusive work environment that fosters collaboration between caregivers from all walks of life. We know that each unique viewpoint is vital in delivering high-quality, safe patient care to everyone who walks through our doors. Our policies, benefits, hiring practices, employee resource groups, and corporate citizenship demonstrate our commitment to inclusion and diversity throughout our system.

Why do we embrace inclusion and diversity? For the Love of Health.

Our Values

We serve together in Love and Excellence. Our unique values, Love and Excellence are bold and powerful, and they are the reason why working for ChristianaCare is special. The behaviors associated with our values guide how caregivers interact with everyone they work with and make for an exceptional work experience. We believe that when you lead with Love, Excellence is inevitable.


ChristianaCare’s comprehensive total rewards package is one of the most competitive in the region. We are proud to offer excellent benefits that reflect the organization’s commitment to being exceptional today and even better tomorrow.

At ChristianaCare, we provide access to high-quality and affordable benefits designed to meet our caregivers where they are. You can tailor your benefits to meet your needs now and adjust them as your priorities change.

Take advantage of ChristianaCare’s wide-ranging benefit offerings from supporting optimal health through medical, prescription, dental and vision coverage to valuable wellness and work/life programs, which include paid parental leave, coverage for infertility and assisted reproductive technologies, an employer-funded short-term disability program, and more.

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Our Region

A Great Place To Live

Our region offers a diversity of cultures, lifestyles, sports and entertainment events, housing options and educational opportunities. Located between Philadelphia and Washington, D.C., our locations provide easy access to two international airports, employment opportunities in a tri-state area, and proximity to some of the nation's top universities and colleges, as well as beaches in MD, DE and NJ!

Why Delaware? Why Maryland?

We Serve Together

For the Love of Health

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