Revenue Integrity Analyst II

 Posted 8 hours ago
     
 $57345.6 - $86028.8 per year
  
2-5 years experience
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AI Summary

The analyst performs advanced charge analysis, CDM governance, and denial root cause investigations to resolve systemic charge capture issues. They are responsible for monitoring reconciliation variances, maintaining revenue integrity dashboards, and partnering with operational leaders to ensure compliance.

Building Location:

Business Service Center

Department:

1006210 REVENUE INTEGRITY - EH SS

Job Description:

Revenue Integrity Analyst II performs advanced charge analysis, CDM governance support,
charge reconciliation oversight, and denial root cause investigation across hospital and/or
professional services. This role independently manages moderate-to-complex revenue
integrity initiatives and partners directly with operational leaders to resolve systemic charge
capture and compliance issues. The Analyst II serves as a subject matter resource for Epic
charge 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

Licensure/Certification Qualifications:

FTE:

1

Possible Remote/Hybrid Option:

Remote

Shift Rotation:

Day Rotation (United States of America)

Shift Start Time:

Days

Shift End Time:

Days

Weekends:

NO

Holidays:

No

Call Obligation:

No

Union:

Union Posting Deadline:

Compensation Range:

$57,345.60 - $86,028.80

Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.

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