Revenue Integrity Account Specialist

Employment Type:
Full time

Shift:
Day Shift

Description:
Loyola Medicine, a member of Trinity Health, is a nationally ranked academic, quaternary care system based in Chicago's western suburbs. With its main campus at Loyola University Medical Center, Loyola Medicine is part of a comprehensive three-hospital system including Loyola University Medical Center, Gottlieb Memorial Hospital, and MacNeal Hospital. 
If you’re passionate about delivering exceptional care and making a difference in the lives of our communities, join the Loyola team and become Loyola Strong!

Shift: 100% remote

What you’ll do:
The Revenue Cycle Analyst analyzes patient clinical and billing data to identify opportunities to improve documentation, coding accuracy, and charge capture. This role resolves pre-bill edits, performs root cause analysis, and partners with cross-functional teams to optimize revenue cycle performance.
This position supports compliance, documentation improvement, and revenue cycle outcomes through audits, reporting, and education. Works closely with clinical teams to ensure accurate documentation aligned with medical necessity, coding, and billing requirements. May require occasional regional travel.

What You’ll Do

• Resolve pre-bill edits (OCE/CCI, claim scrubber edits, DNFB) within established timelines
• Analyze data to identify documentation, coding, and charge capture opportunities
• Conduct root cause analysis and support denial prevention efforts
• Partner with clinical teams to ensure accurate documentation and billing alignment
• Stay current on payer requirements and regulatory changes
• Collaborate with Patient Business Services (PBS) on payer requests and claims
• Support revenue optimization and charge control initiatives
• Prepare timely, accurate reports
• Ensure compliance with all applicable regulations and policies
• Perform other duties as assigned

We offer our Revenue Integrity Account Specialist:

• Benefits from Day One 
• DailyPay! Work today/Get paid today 
• Tuition Reimbursement 
• Career Development
• Referral Rewards 
• Strong Team Culture 
• Career Growth Opportunities 

What you’ll need for this job:
Education& Certifications

• Associate’s or Bachelor’s degree in Healthcare Administration, Business, Finance, Accounting, Nursing, or a related field
• One or more of the following certifications preferred:
• RHIA, RHIT, CCS
• CPC/COC (AAPC)
• Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN)
• Certified in Healthcare Compliance (CHC/CDC preferred)
• CHRI certification or membership strongly preferred

Experience

• Minimum of 3 years of experience in revenue cycle operations, including billing, charge capture, auditing, or related functions

Knowledge& Skills:Strong understanding of:

• Clinical workflows and documentation processes
• Charge master maintenance and charge capture
• Medical coding systems (CPT, HCPCS, ICD-10, revenue codes, modifiers)
• Billing and reimbursement methodologies
• Revenue cycle processes, including audits and reconciliation

Familiarity with:

• APC and OPPS reimbursement structures
• Pre-bill edits (OCE, CCI) and DNFB workflows
• Knowledge of third-party payer regulations and requirements
• Advanced proficiency in Microsoft Excel; experience with Access and Business Objects preferred; strong skills in Word and PowerPoint
• Excellent analytical, organizational, and problem-solving abilities
• Strong interpersonal, written, and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment

Compensation
Pay Range: $20.02 - $31.03 per hour
Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.

Benefits:
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Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.