Revenue Integrity Account Specialist

Employment Type:Full timeShift:Day ShiftDescription: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% remoteWhat 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 DoResolve pre-bill edits (OCE/CCI, claim scrubber edits, DNFB) within established timelinesAnalyze data to identify documentation, coding, and charge capture opportunitiesConduct root cause analysis and support denial prevention effortsPartner with clinical teams to ensure accurate documentation and billing alignmentStay current on payer requirements and regulatory changesCollaborate with Patient Business Services (PBS) on payer requests and claimsSupport revenue optimization and charge control initiativesPrepare timely, accurate reportsEnsure compliance with all applicable regulations and policiesPerform other duties as assignedWe 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 & CertificationsAssociate’s or Bachelor’s degree in Healthcare Administration, Business, Finance, Accounting, Nursing, or a related fieldOne or more of the following certifications preferred:RHIA, RHIT, CCSCPC/COC (AAPC)Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN)Certified in Healthcare Compliance (CHC/CDC preferred)CHRI certification or membership strongly preferredExperienceMinimum of 3 years of experience in revenue cycle operations, including billing, charge capture, auditing, or related functionsKnowledge & Skills:Strong understanding of:Clinical workflows and documentation processesCharge master maintenance and charge captureMedical coding systems (CPT, HCPCS, ICD-10, revenue codes, modifiers)Billing and reimbursement methodologiesRevenue cycle processes, including audits and reconciliationFamiliarity with:APC and OPPS reimbursement structuresPre-bill edits (OCE, CCI) and DNFB workflowsKnowledge of third-party payer regulations and requirementsAdvanced proficiency in Microsoft Excel; experience with Access and Business Objects preferred; strong skills in Word and PowerPointExcellent analytical, organizational, and problem-solving abilitiesStrong interpersonal, written, and verbal communication skillsAbility to manage multiple priorities in a fast-paced environmentCompensationPay 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:  Click or copy URL to your browser www.trinity-health.org/sites/default/files/my-benefits/Health-and-Wellbeing/Compliance/Illinois-Transparency-Law/Trinity-Health-Summary-of-Benefits-Illinois-Job-Req-Discloser-Law.pdf 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.