Revenue Integrity Analyst

About the role

The Revenue Integrity Analyst plays a critical role in supporting the financial health and regulatory compliance of Ventura County Medical Center, Santa Paula Hospital, and affiliated ambulatory clinics. Under the general direction of the Revenue Integrity Manager, the incumbent performs advanced analytical, consultative, and project leadership work to support the County's Revenue Integrity Program.

Responsibilities

• Captures and maintains accurate charge data in the Chargemaster (CDM).
• Evaluates and recommends changes to charge capture, coding, and billing practices to optimize reimbursement and regulatory compliance.
• Supports the implementation of new clinical services and operational initiatives through data analysis and process improvement.
• Collaborates with clinical departments, finance, patient financial services, compliance, health information management, and informatics to resolve complex charging, coding, billing, and reimbursement issues.
• Develops and implements policies, procedures, and workflow recommendations related to revenue integrity, coding, charging, reimbursement, and regulatory compliance.
• Provides technical consultation and education to physicians, department leadership, and operational staff regarding reimbursement, charge capture, coding, and documentation requirements.
• Analyzes reimbursement trends, denials, payment variances, and operational data to identify root causes and recommend corrective actions.
• Prepares reports, dashboards, and presentations utilizing Microsoft Excel and other reporting tools to support operational and executive decision-making.
• Participates in multidisciplinary committees, strategic initiatives, and special projects supporting revenue cycle optimization and organizational goals.

Requirements

The ideal candidate is a collaborative healthcare revenue cycle professional with strong analytical abilities and experience interpreting complex reimbursement and regulatory requirements. They possess a solid understanding of healthcare coding, billing, charge capture, and reimbursement methodologies and are skilled at translating technical requirements into practical operational solutions. The successful candidate is comfortable working with multidisciplinary teams, managing multiple priorities, developing data-driven recommendations, and communicating effectively with physicians, operational leaders, and executive leadership.

Qualifications

• A bachelor's degree in healthcare administration, business administration, public administration or a related field.
• One (1) year of experience in revenue integrity, hospital professional coding/billing experience, or revenue optimization.
• Necessary special requirements: Candidates must possess and maintain a current coding certification from a nationally recognized organization.

Skills

• Working knowledge of Medicare, Medi-Cal, and commercial payer reimbursement methodologies.
• National Correct Coding Initiative (NCCI) and Outpatient Prospective Payment System (OPPS) and Ambulatory Payment Classification (APC) methodologies.
• Revenue codes, charge capture principles, and Chargemaster (CDM) governance.
• Federal and state healthcare regulations and compliance requirements.
• Microsoft Excel, including formulas, PivotTables, XLOOKUP/VLOOKUP, data validation, and analytical reporting.
• Intermediate proficiency in Electronic health record systems (Cerner Millennium or similar) and healthcare reporting applications.
• Intermediate Business intelligence and reporting tools (e.g., Power BI or similar).

Benefits

Payroll Title: Staff/Services Manager I
Department/Agency: Health Care Agency Administration
Educational/Bilingual Incentive: Possible educational incentive of 2.5%, 3.5%, or 5% based on completion of Associate's, Bachelor's, or Master's degree. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.

Pay

Staff/Services Manager I is a management classification and is not eligible for overtime compensation. Incumbents in these classifications are eligible for benefits at the MB3 level.

Schedule

The tentative schedule opening date is July 22, 2026 and the closing date is July 29, 2026 at 5:00 p.m.