Revenue Integrity Analyst

About the role

The Revenue Integrity Analyst owns the accuracy and integrity of the Epic charge description master and related revenue integrity functions, serving as a key resource for charge capture, reconciliation, pricing, and compliance across clinical and financial operations.

Responsibilities

• Own the accuracy and integrity of the Epic charge description master, including charge codes, descriptions, CPT/HCPCS assignment, revenue codes, modifiers, units of service, and effective dating.
• Maintain fee schedule groups and pricing records; ensure price changes are applied to the correct entities.
• Maintain charge routing rules, charge triggers, and order-entry linkage.
• Identify and pursue missing charges through late charge analysis, revenue and usage variance review, and department reconciliation exception reporting.
• Analyze reimbursement variances where the root cause is charge or CDM related.
• Monitor high-risk charging areas on a defined cadence for high-dollar areas.
• Develop and deliver role-based charge capture and reconciliation training for all end-users.
• Serve as first-line consultant to clinical departments on how a new service, order, supply, or drug should be built, charged, and reconciled.
• Perform routine charge audits validating that services provided are documented, charged, coded, billed, and reimbursed correctly and consistently.
• Perform any other audits as requested.
• Lead the annual pricing update process in partnership with Finance and Managed Care, including modeling of price change impact by payer, service line, and volume.
• Serve as operational lead to the Financial Integrity Committee.
• Ensure that build decisions are coordinated amongst all parties.
• Maintain a centralized log of CDM requests.

Requirements

• Bachelor's degree in health information management, healthcare administration, finance, business, nursing, or a related field; equivalent directly relevant experience may be substituted.
• Minimum five (5) years of hospital revenue cycle experience with direct chargemaster, revenue integrity, or hospital billing responsibility.
• Demonstrated working knowledge of CPT, HCPCS, revenue codes, modifiers, UB-04 claim structure, NCCI and MUE edits, and OPPS/APC methodology.
• Demonstrated ability to analyze charge, revenue, and reimbursement data and to communicate findings to both clinical and financial audiences.
• Demonstrated experience training or advising non-financial clinical staff on charge capture.
• Strong Excel skills; ability to work with large charge and claim data extracts.

Pay

Salary Range: $90,771.00–$149,739.00 USD annually. Competitive base rates are determined by job-related work experience, internal equity, and industry-specific market data. Some positions may be eligible for clinical certification pay and shift differentials. The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status.

Benefits

• Medical, dental, and vision insurance
• Savings accounts and voluntary benefits
• Wellness programs and discounts
• Paid life insurance
• Generous 401(k) match
• Adoption assistance
• Back-up daycare
• Free onsite parking
• Recognition rewards
• Fully paid tuition program or generous tuition assistance program