R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.
As our Revenue Integrity Analyst, you play a key role in maintaining the accuracy, compliance, and efficiency of the charge master. You are responsible for conducting in-depth audits, analyzing complex billing issues and supporting departments in ensuring accurate charge capture and reimbursement. To thrive in this role, you must have a coding background.
Responsibilities:
Prepares Excel analysis, including V-Lookups and pivot tables. Gathers and compiles data in a systematic fashion, clearly documenting assumptions, and validating accuracy of information to resolve inconsistencies.
Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines.
Conducts Charge Capture Audits: Review and analyze patient records, billing data, and financial statements to ensure charge and coding compliance. Identify discrepancies or errors and develop action plan for future state resolution
Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams.
Monitor regulatory changes and payer updates that may impact charge master and revenue integrity.
Collaborates with various departments to resolve CDM or RI discrepancies (Utilization Management (UM), Clinical Documentation Integrity (CDI), RCM, Coding Services, Clinical Departments, and Health Information Management (HIM)).
Serve as a liaison during system upgrades, new service implementation, and pricing reviews.
Responsibilities and experience required in the following:
Maintain and update the Charge Description Master (CDM)
Sox Control regulations
Ensure charges comply with:
CMS (Medicare OPPS/IPPS) rules
NCCI edits
Local Coverage Determinations (LCDs) / NCDs
Payer-specific billing requirements
Validate correct assignment of:
HCPCS/CPT codes
Modifiers
Units of service
Monitor annual/quarterly code updates (e.g., CPT, HCPCS, APC changes)
Review clinical workflows to ensure all billable services/supplies are captured
Identify missed revenue opportunities (undercharges, missing charges)
Partner with departments (Radiology, OR, Cath Lab, etc.) to validate charge practices
Analyze denials tied to:
Incorrect HCPCS/CPT
Missing modifiers
Bundling/edit issues
Recommend CDM or workflow fixes to prevent recurrence
Investigate and resolve:
Charge errors
Denials related to coding or CDM setup
Requirements:
3+ years coding experience
Hospital coding experience
Experience with Charge Capture Audits
CCS, CIRCC, COC, CPC or equivalent preferred
EPIC experience preferred
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.
If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.
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To learn more, visit: R1RCM.com
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Skills Required
- 3+ years coding experience
- Hospital coding experience
- Experience with Charge Capture Audits
- CCS, CIRCC, COC, CPC or equivalent certification
- EPIC experience
- Maintain and update the Charge Description Master (CDM)
- Knowledge of SOX control regulations
- Knowledge of CMS (Medicare OPPS/IPPS) rules
- Knowledge of NCCI edits
- Knowledge of LCDs/NCDs and payer-specific billing requirements
- Ability to validate HCPCS/CPT codes, modifiers, and units of service
- Proficiency in Excel including VLOOKUPs and pivot tables
- Ability to analyze denials and recommend CDM or workflow fixes
R1 RCM Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about R1 RCM and has not been reviewed or approved by R1 RCM.
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Leave & Time Off Breadth — Flexible or unlimited PTO, paid holidays/vacation, and paid volunteer time are highlighted, supporting work-life balance in many roles. Time-off usability is described as workable in many teams, especially in exempt roles.
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Flexible Benefits — Remote work options and flexible schedules are available for many positions, offering convenience and adaptability depending on role and location. Work-from-home eligibility varies by position but is called out as a valued option.
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Career-Linked Recognition & Rewards — Recognition programs such as R1 Stars are implemented to boost engagement and morale. Feedback suggests these programs help reduce turnover and provide acknowledgment beyond base pay.
R1 RCM Insights
What We Do
R1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers R1’s proven and scalable operating models seamlessly complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
