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 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.
Key responsibilities
- Conduct detailed charge reviews for high-risk departments such as surgery, ED, infusion, and 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 a related field, or equivalent experience.
- 3-5 years of experience in Revenue Integrity, Revenue Cycle, Coding, CDM Maintenance, Healthcare Finance, or a related field.
- Strong knowledge of CPT/HCPCS, revenue codes, CMS billing regulations, and NCCI/MUE edits relating to health care services.
Preferred qualifications
- Strong knowledge of the clinical and business structures of a complex, integrated healthcare delivery system.
- Experience with Epic Resolute preferred.
- Advanced Excel and analytical skills.
- Experience with Microsoft Office applications.
Medical, dental, vision, life, and disability insurance
Supplemental insurance options
401(k) plan with employer contributions
Training, tuition reimbursement, and educational programs
Flexible scheduling
Generous time off
Wellness resources focused on physical, mental, and emotional health
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago