Job Description
Job Description:
Revenue Integrity Analyst II performs advanced charge analysis, CDM governance support,charge reconciliation oversight, and denial root cause investigation across hospital and/orprofessional services. This role independently manages moderate-to-complex revenueintegrity initiatives and partners directly with operational leaders to resolve systemic chargecapture and compliance issues. The Analyst II serves as a subject matter resource for Epiccharge build workflows, reconciliation controls, and regulatory billing requirements.Education Qualifications:
Key Responsibilities
• Conduct detailed charge reviews for high-risk departments (e.g., surgery, ED, infusion,
radiology).
• Review and validate Epic charge build elements including CPT/HCPCS, revenue
codes, modifiers, and routing logic.
• Monitor and investigate reconciliation variances and charge lag trends.
• Perform root cause analysis for charge-related denials and implement corrective
recommendations.
• Assist with CDM standardization and regulatory update implementation.
• Develop and maintain revenue integrity dashboards and KPIs.
• Identify revenue leakage patterns and propose workflow or system improvements.
• Provide education and guidance to operational leaders on charge capture and
compliance expectations.
• Participate in cross-functional projects with Finance, Coding, Compliance, and IT.
Required Qualifications
• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field (or equivalent experience)
• 3–5 years of experience in Revenue Integrity, Revenue Cycle, Coding, CDM
Maintenance, Healthcare Finance, or related field
• Strong knowledge of CPT/HCPCS, revenue codes, CMS billing regulations,
NCCI/MUE edits relating to health care services
Preferred Qualifications
• Strong knowledge of clinical and business structures of a complex, integrated
healthcare delivery system
• Experience with Epic Resolute preferred
• Advanced Excel and analytical skills; experience with all Microsoft Office applications
preferred