Senior Revenue Integrity Analyst - Charge Build/Foundation
Job Description
Job Description:
The Senior Revenue Integrity Analyst – Charge Build/Foundation serves as the enterprise subject matter expert for charge configuration, Epic build integrity, and chargemaster (CDM) governance. 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.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