Senior Revenue Integrity Analyst - Charge Optimization

Building Location:
Business Service Center

Department:
1006210 REVENUE INTEGRITY - EH SS

Job Description:
The Senior Revenue Integrity Analyst - Charge Optimization is responsible for improving charge capture accuracy, strengthening reconciliation processes, reducing denials, and optimizing charging workflows across hospital and/or professional services. This role focuses on identifying revenue leakage, analyzing operational breakdowns, and implementing sustainable process improvements that enhance revenue performance and compliance. This role partners with Clinical Departments, Patient Access, Billing, Finance, Coding, Compliance, Informatics, and IT to proactively monitor charging practices, correct systemic issues, and prevent downstream billing errors. This position plays a key role in denial prevention, charge reconciliation oversight, and operational accountability.

Education Qualifications:

Key Responsibilities:

• Lead EPIC (HB/PB) charge build, including CPT/HCPCS, revenue codes, modifiers, pricing, GL mapping, router rules, and testing for new or expanded services
• Maintain and govern the chargemaster through regulatory updates, CDM standardization, defensible pricing, and price transparency accuracy
• Partner with IT and Clinical Informatics to ensure compliant and optimized charge setup
• Establish and monitor charge reconciliation controls, policies, education, variance investigation, and escalation of financial risk
• Promote alignment with Epic Foundation principles and Epic Gold Standard workflows
• Oversee charge capture performance, monitoring charge lag, work queues, and root causes of missed or incorrect charges
• Implement systemic corrections to prevent recurring issues
• Conduct denial root cause analysis, monitor payer edits, and implement build and workflow corrections in partnership with operational, IT, and Revenue Cycle leaders
• Develop and maintain revenue integrity dashboards, KPIs, and reports to help inform and guide leadership actions
• Serve as escalation point for complex issues and mentor Revenue Integrity team members while leading cross-functional optimization initiatives

Education Requirements:

• Bachelor's degree in a related field
• Extensive relevant experience may be considered in lieu of formal education.

Required Qualifications:

• Epic Resolute (HB and/or PB) experience
• 5+ years in Revenue Integrity, CDM Build/Maintenance, Revenue Cycle, Coding, or healthcare finance
• Advanced knowledge of CPT/HCPCS, revenue codes, CMS billing regulations, charge build workflows and CDM governance
• Strong proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook), including advanced Excel skills for data analysis and reporting

Preferred Qualifications:

• Epic HB or PB certification
• CRCR, CHRI, CPC, CCS, RHIA, RHIT or similar certification
• Experience leading charge standardization initiatives in an integrated health system
• Knowledge of payer contracts and reimbursement methodologies

Licensure/Certification Qualifications:

FTE:
1

Possible Remote/Hybrid Option:
Remote

Shift Rotation:
Day Rotation (United States of America)

Shift Start Time:
Days

Shift End Time:
Days

Weekends:
NO

Holidays:
No

Call Obligation:
No

Union:

Union Posting Deadline:

Compensation Range:
$62,691.20 - $94,036.80

Employee Benefits at Essentia Health:At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at View phone number on click.appcast.io.