Senior Revenue Integrity Analyst - Charge Build/Foundation
@ 1000 Essentia HealthSenior Revenue Integrity Analyst - Charge Build/Foundation
About the job
Essentia Health is a healthcare provider focusing on quality care and innovation. This role involves managing charge configuration, ensuring revenue integrity, and collaborating across departments to optimize revenue cycle processes and compliance.
Requirements
- Epic Resolute experience
- 5+ years healthcare finance
- Knowledge of CPT/HCPCS
- Proficiency in Microsoft Office
- Experience with revenue cycle
Qualifications
- Bachelor’s degree or equivalent
- Epic HB or PB certification preferred
- Relevant certifications (CRCR, CPC, RHIA)
- Leadership in charge standardization
- Understanding of payer contracts
Full job description
Building Location:
Business Service CenterDepartment:
1006210 REVENUE INTEGRITY - EH SSJob Description:
Essentia is looking for a Senior Revenue Integrity Analyst who serves as the enterprise subject matter expert for charge configuration, Epic build integrity, and chargemaster (CDM) governance.Education Qualifications:
This role is responsible for ensuring the foundational accuracy of charge build within Epic, including CPT/HCPCS assignment, revenue code mapping, modifier logic, pricing alignment, and general ledger linkage. This position safeguards the structural integrity of the organization’s revenue cycle by overseeing new charge build requests, maintaining CDM accuracy, supporting regulatory updates, and ensuring standardized charge configuration across all facilities and service lines. This role works proactively and cross-functionally with Finance, Coding, Compliance, Patient Access, Billing, Clinical Departments, Informatics, and IT to prevent downstream denials, revenue leakage, and compliance risk.
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:
1Possible Remote/Hybrid Option:
RemoteShift Rotation:
Day Rotation (United States of America)Shift Start Time:
8:00amShift End Time:
5:00pmWeekends:
NOHolidays:
NoCall Obligation:
NoUnion:
Union Posting Deadline:
Compensation Range:
$62,691.20 - $94,036.80Employee 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 (218) 576-0000.Similar jobs in Duluth, MN
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