Revenue Integrity Analyst II - Pathology and Radiology Coding

Role Overview

• Serve as a subject matter expert on revenue integrity, charge capture, diagnostic coding, and billing compliance.
• Perform comprehensive reviews of Charge Description Master (CDM) records to ensure coding accuracy, compliance, and ongoing integrity.
• Investigate coding and charging discrepancies, identify root causes, and implement standardized corrective actions.
• Manage and resolve Revenue Integrity tickets related to coding edits, charge capture issues, CDM maintenance, and billing discrepancies while maintaining clear audit trails.
• Partner with Diagnostic Coding teams, including Radiology and Pathology coders, to ensure accurate application of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines.
• Evaluate Epic work queues, coding edits, and charge review reports to identify reimbursement risks and revenue leakage opportunities.
• Collaborate with Revenue Operations, HIM, Billing, and Clinical departments on quarterly and annual coding updates and regulatory changes.
• Educate clinical departments and operational stakeholders on coding requirements, charge capture accuracy, documentation standards, and compliant billing practices.
• Present coding audit findings, revenue integrity trends, and process improvement recommendations to leadership and governance committees.

Key Qualifications

• Bachelor's degree or equivalent combination of education and relevant healthcare revenue cycle experience.
• Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, charge capture processes, and billing compliance requirements especially related to LCD NCD regulations.
• Professional coding certification required or strongly preferred, including CPC, COC, CCS, RHIA, or RHIT.
• Experience collaborating with coding, HIM, revenue cycle, finance, and clinical teams within a complex healthcare environment.
• Demonstrated experience analyzing coding edits, denials, charge reconciliation issues, and reimbursement impacts.
• Epic experience and familiarity with revenue cycle applications, coding work queues, and charge review tools preferred.

Core Skills

• Advanced analytical skills with the ability to identify coding trends, documentation gaps, workflow deficiencies, and compliance risks.
• Strong understanding of healthcare reimbursement methodologies, coding regulations, and revenue cycle operations.
• Ability to communicate complex coding and revenue integrity concepts clearly to clinical, operational, and leadership audiences.
• Proven ability to conduct coding education, training, and audit feedback sessions that drive sustainable improvements.
• Strong organizational, problem-solving, and cross-functional collaboration skills with a focus on accuracy, accountability, and continuous process improvement.

Additional Information

• Schedule: 9:00 AM - 5:00 PM EST, Monday - Friday
• Location: Hybrid; Primary remote with on site as needed at 633 Third Avenue, New York, NY
• Reporting To the Director, Revenue Integrity

Helpful Links: Compensation Philosophy

Pay Range

$83,800.00 - $134,000.00

FSLA Status: Exempt

Closing

At MSK, we believe in fair, competitive pay that reflects your job, experience, and skills.