{"id":3846729,"url":"https://alion.io/job/guidehouse-revenue-integrity-coding-billing-specialist","title":"Revenue Integrity Coding Billing Specialist","company":{"id":4179,"name":"Guidehouse","domain":"guidehouse.com","url":"https://alion.io/company/guidehouse","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"services","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":82,"open_postings":119,"ghost_share":0,"stale_share":0.714,"repost_share":0.017,"time_to_fill_p50_days":29,"computed_at":"2026-11-09T06:03:00Z"}},"role":"Finance","role_family":"Finance","seniority":"senior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Birmingham, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":59000,"max":98000,"currency":"USD","period":"year","gross":null,"usd_annual":98000},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-11-05T00:00:00Z","employer_posted_date":"2026-11-05","last_verified_at":"2026-11-10T03:48:43Z","board_verified":true,"closed_at":null,"days_open":5,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":5},"description":"Job Family:\nGeneral CodingTravel Required:\nNoneClearance Required:\nNoneWhat You Will Do:\nUnder the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote. Daily duties for this position include: \nResponsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. \nTasks associated with this work include resolving standard billing edits such as:Correct Coding Initiatives (CCI)Medically Unlikely Edits (MUE)Medical Necessity editsOther claim level edits as assigned \nAs needed, review clinical documentation and diagnostic results as appropriate to validate and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system.\nEnsures coding and billing practices are in compliance with Federal/State guidelines by utilizing various types of authoritative information.Maintains current knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements.\nOther duties commensurate with skills and experience as determined by the Director of Revenue Integrity.\n What You Will Need:\nHigh School Diploma (Relevant experience may be substituted for formal education)\n5+ years of Revenue Integrity experience\nAAPC or AHIMA coding certification. \nExperience in ICD-10, CPT and HCPCS Level II Coding.\nExpertise in determining medical necessity of services provided and charged based on provider/clinical documentation.\nKnowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims.\nProficiency in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy)\nKnowledge of current code bundling rules and regulations along with proficiency on issues regarding compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG’s.\nKnowledge and understanding of hospital charge description master coding systems and structures.\nStrong verbal, written and interpersonal communication skills.\nAbility to produce accurate, assigned work product within specified time frames.\nWhat Would Be Nice To Have:\n5 years' experience in Revenue Integrity Coding and Billing\nHospital medical billing and auditing experience\nAssociate's degree\n#IndeedSponsored\nThe annual salary range for this position is $59,000.00-$98,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer:\nGuidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.\nBenefits include:\nMedical, Rx, Dental & Vision Insurance\n\nPersonal and Family Sick Time & Company Paid Holidays\n\nPosition may be eligible for a discretionary variable incentive bonus\n\nParental Leave\n\n401(k) Retirement Plan\n\nBasic Life & Supplemental Life\n\nHealth Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts\n\nShort-Term & Long-Term Disability\n\nTuition Reimbursement, Personal Development & Learning Opportunities\n\nSkills Development & Certifications\n\nEmployee Referral Program\n\nCorporate Sponsored Events & Community Outreach\n\nEmergency Back-Up Childcare Program\n\nAbout Guidehouse\nGuidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.\nGuidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.\nIf you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.\nAll communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.\nIf any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.\nGuidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.","description_format":"text","description_chars":6310,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":["Parental leave","Retirement plans","Vision insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Digital Government","IT Consulting & Digital Transformation","Management Consulting"],"lifecycle":[{"event":"open","at":"2026-11-06T01:03:33Z"}],"visa":[{"country":"US","licensed_sponsor":true,"adverts_offering_sponsorship_24m":0,"sanctioned_now":false,"evidence":"H-1B filings in 12 months: 63 · green card filings: 27","filings_12m":63,"filings_prev_12m":57,"green_card_filings_12m":27,"median_offered_wage_usd":128889,"route":null,"cap_exempt":false,"checked_at":"2026-11-09T07:32:21+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":63,"band":"ok","label":"Likely open","p_open":1,"p_active":0.632,"p_room":1,"age_days":4,"expected_fill_days":29,"reasons":["conf:0","stale_co","velocity","win:early","comp:brand"],"computed_at":"2026-11-09T06:03:00Z"},"pay":{"stated_usd_annual":98000,"is_top_pay":false},"html_url":"https://alion.io/job/guidehouse-revenue-integrity-coding-billing-specialist","json_url":"https://alion.io/job/guidehouse-revenue-integrity-coding-billing-specialist.json","meta":{"generated_at":"2026-11-10T04:59:04Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":11654,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-11T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.1,"usd":0.01,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4179},"rest":"https://alion.io/mcp/rest/get_company?id=4179"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fguidehouse-revenue-integrity-coding-billing-specialist"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":2,"usd":0.2},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fguidehouse-revenue-integrity-coding-billing-specialist"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.1,"usd":0.01},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fguidehouse-revenue-integrity-coding-billing-specialist"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/guidehouse-revenue-integrity-coding-billing-specialist\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fguidehouse-revenue-integrity-coding-billing-specialist"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3846729}},{"tool":"search_jobs","arguments":{"company":"guidehouse.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3846729},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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