Analysis Skills, Auditing, Billing, Claims Management, Communication Skills, Contract Requirements, Corrective Action, Cross-Functional, Data Analysis, Detail Oriented, Documentation, Electronic Medical Records, Financial Management, Financial Operations, Follow Through, Government, Government Contracts, Government Regulations, Healthcare, Healthcare Reimbursement, Legal, Maintain Compliance, Managed Care, Medicaid, Medical Billing, Medical Record System, Medicare, Microsoft Excel, Multitasking, Operational Audit, Presentation/Verbal Skills, Problem Solving Skills, Process Development, Process Improvement, Psychiatry and Mental Health, Regulations, Reimbursement, Revenue Analysis, Revenue Management, Root Cause Analysis, Supplier Optimization, System Validation, Systems Administration/Management, Time Management, Trend Analysis, Willing to Travel, Women's Health, Writing Skills
RCM Billing Integrity Analyst
Hourly Compensation Range: $24.00 - $29.00 per hour, full-time, benefit eligible
Profession: Revenue Cycle Management / Healthcare Billing & Reimbursement
Location: This position is primarily remote; however, candidates need to reside in the Upstate South Carolina region and be available to attend occasional meetings or business needs at the Greenville, SC Corporate Headquarters.
Travel: May require occasional travel to the Corporate office or offsite meetings.
About the Opportunity
OB Hospitalist Group (OBHG) is seeking a detail-oriented and analytical Billing Integrity Analyst to join our Revenue Cycle Management (RCM) team. This role is critical to ensuring the accuracy, compliance, and integrity of our healthcare billing processes and reimbursement practices. The Billing Integrity Analyst will work cross-functionally with coding, managed care, payer enrollment, and external vendor partners to optimize billing accuracy, reduce denials, and improve overall financial performance.
If you are passionate about healthcare revenue cycle operations, claims analysis, payer regulations, and process improvement, we encourage you to apply.
What Youll Do
As a Billing Integrity Analyst, you will:
- Research and analyze government and managed care billing guidelines to ensure compliance and operational accuracy.
- Audit claim setup configurations, identify discrepancies, and follow through to resolution.
- Develop and maintain billing and claims documentation, policies, and procedures.
- Review billing transactions, claims, and reimbursement data for accuracy and compliance.
- Investigate claim denials, billing issues, and claim edits while recommending system enhancements to reduce future denials.
- Monitor compliance with payer contracts, government regulations, and organizational policies.
- Collaborate with Coding, Managed Care, Payer Enrollment, and vendor partners to improve billing outcomes.
- Identify process improvement opportunities and recommend corrective actions.
- Perform root-cause analysis of billing errors and implement preventative solutions.
- Validate billing system configurations and workflows to ensure accurate claim generation.
- Maintain detailed audit records, findings, and corrective action documentation.
- Stay current on reimbursement methodologies, payer guidelines, and industry regulatory changes.
Required Qualifications
- Strong analytical, investigative, and problem-solving abilities.
- Advanced Microsoft Excel skills and experience utilizing data analysis tools.
- Experience working with healthcare billing, claims management, and revenue cycle systems.
- Knowledge of healthcare reimbursement methodologies and payer contracts.
- Exceptional attention to detail and commitment to accuracy.
- Strong verbal and written communication skills.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Preferred Qualifications
- 3-5 years of experience in healthcare billing, revenue cycle management, claims auditing, reimbursement analysis, or related healthcare financial operations.
- Experience working with healthcare billing systems and EMR/EHR platforms.
- Knowledge of Medicare, Medicaid, and commercial payer requirements.
- Experience identifying denial trends and implementing corrective actions.
- Familiarity with payer enrollment processes and managed care contract requirements.
Why Join OBHG?
Join the forefront of womens healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating 20 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of womens healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination!
What We Offer - The Good Stuff:
- A mission based company with an amazing company culture
- Paid time off & holidays so you can spend time with the people you love
- Medical, dental, and vision insurance for you and your loved ones
- Health Savings Account (with employer contribution) or Flexible Spending Account options
- Employer Paid Basic Life and AD&D Insurance
- Employer Paid Short- and Long-Term Disability w Optional Short Term Disability Buy-up plan
- Paid Parental Leave
- 401(k) Savings Plan with match
- Legal Plan & Identity Theft Services
- Mental health support and resources
Equal Opportunity Employer
OB Hospitalist Group is an Equal Opportunity Employer committed to fostering a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, genetic information, sexual orientation, gender identity, or any other protected characteristic under applicable law.