Note: The job is a remote job and is open to candidates in USA. Essentia Health is a healthcare organization seeking a Senior Revenue Integrity Analyst – Charge Build/Foundation. This role serves as the subject matter expert for charge configuration and governance, ensuring accuracy in charge build within Epic and overseeing new charge requests to maintain the integrity of the revenue cycle.
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
Skills
- 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
- Bachelor's degree in a related field
- Extensive relevant experience may be considered in lieu of formal education
- 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
Benefits
- Medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs
- 401(k) plan with employer contributions to help you plan for the future
- Training, tuition reimbursement, and educational programs
- Flexible scheduling
- Generous time off
- Wellness resources focused on your physical, mental, and emotional health
Company Overview
Essentia Health is a non-profit organization that offers integrated health care facilities to its patients. It was founded in 2004, and is headquartered in Duluth, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.essentiahealth.org/.