Senior Revenue Integrity Analyst - Charge Optimization
About The Position
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.
Requirements
- 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
Nice To Haves
- 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
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
Benefits
- medical insurance
- dental insurance
- vision insurance
- life insurance
- disability insurance
- 401(k) plan with employer contributions
- training
- tuition reimbursement
- educational programs
- flexible scheduling
- generous time off
- wellness resources
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What This Job Offers
Job Type
Full-time
Career Level
Senior
