Senior Revenue Integrity Analyst - Charge Build/Foundation

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