Senior Solution Technical Expert (Revenue Integrity)

TL;DR

Senior Solution Technical Expert (Revenue Integrity): Providing enterprise-level subject matter expertise in coding, charge capture, and denial management for the Defense Health Agency with an accent on MHS GENESIS platform optimization and revenue integrity analytics. Focus on resolving complex claim edits, identifying systemic root causes for revenue leakage, and ensuring compliant billing across the Military Health System.

Location: Must be based in the continental United States

Company

hirify.global is a federal government contracting business that supports mission-critical needs of federal civilian, defense, and intelligence community customers.

What you will do

• Serve as an enterprise subject matter expert for coding, billing, and revenue integrity across inpatient and outpatient services.
• Analyze and resolve complex claim edits, pre-bill holds, and suspended charges within MHS GENESIS.
• Reconcile and interpret DHA revenue cycle data to identify coding, billing, and denial risks.
• Evaluate charge capture workflows to ensure services are mapped, priced, and transmitted accurately.
• Develop corrective action recommendations based on systemic trends in coding defects and reimbursement discrepancies.
• Design executive-level reporting and presentations summarizing financial exposure and recovery opportunities.

Requirements

• United States citizenship is required due to government contract requirements.
• Bachelor’s degree in a clinical, healthcare, or business field (or Associate’s degree plus 5 years of relevant experience).
• Active coding certification from AHIMA or AAPC (e.g., CCS, CPC, COC, CIC).
• 5+ years of progressive medical coding and billing experience, specifically in revenue integrity or denial management.
• Ability to obtain and maintain a Federal or DoD Public Trust clearance.
• Expert knowledge of ICD-10, CPT, HCPCS, NCCI edits, and payer edit logic.

Nice to have

• Experience with Oracle Health Cerner revenue cycle workflows and MHS GENESIS.
• Working knowledge of DHA data repositories like HealtheAnalytics, M2, or EAS IV.
• Proficiency in business intelligence tools such as Power BI or Tableau.
• Professional certifications like CRCR, RHIA, RHIT, or PMP.

Culture & Benefits

• Comprehensive benefits package including medical, dental, vision, life, and disability insurance.
• Retirement 401(k) plan participation.
• Flexible work-life balance and professional development opportunities.
• Collaborative work environment focused on supporting the Seneca Nation.