Revenue Integrity Manager - Charge Optimization

Building

Location:

Business Service Center

Department:

1006210 REVENUE INTEGRITY - EH SS

Job Description:

The Revenue Integrity Manager - Charge Optimization leads enterprise efforts to improve charge capture accuracy, strengthen reconciliation controls, reduce preventable denials, and optimize charging workflows across hospital and professional services. This role focuses on identifying revenue leakage, correcting systemic workflow breakdowns, and implementing sustainable process improvements that enhance financial performance and compliance.

The Manager oversees Revenue Cycle team members responsible for reconciliation monitoring, denial root cause mitigation, workflow optimization, and charge lag opportunities. This role partners with Clinical Departments, Patient Access, Billing, Finance, Coding, Compliance, Informatics, and IT to proactively monitor charging practices and workflows, and prevent downstream billing errors. This position plays a key role in denial prevention, charge reconciliation oversight, and operational accountability.

Education

Qualifications:

Key Responsibilities

* Establish and monitor enterprise reconciliation controls across clinical source systems and Epic billing modules.

* Drive reconciliation automation initiatives in partnership with Informatics and IT and ensure reconciliation compliance across all hospitals and high-risk departments.

* Monitor variance thresholds and escalate financial risk.

* Evaluate and redesign charge capture workflows to reduce missed and late charges.

* Monitor charge lag performance and department-level accountability.

* Identify systemic or workflow breakdowns contributing to revenue leakage.

* Educate operational leaders on charge accountability and risk mitigation and promote operational accountability for charge performance.

* Oversee denial trend analysis related to charge capture and workflow issues and develop/assist with corrective actions to prevent recurring denials.

* Direct team members in optimizing Epic workflows, automation, and reporting.

* Develop and monitor KPIs including charge lag, reconciliation compliance, denial rates, and revenue leakage.

* Present optimization progress and ROI metrics to executive leadership.

* Translate analytics into operational improvement strategies.

* Lead cross-functional optimization initiatives.

* Foster a proactive revenue protection culture across the system.

* Mentor and develop Revenue Integrity team members.

Education Requirement:

Bachelor's degree in Healthcare Administration, Finance, Business, or related field (or equivalent experience)

Required Qualifications:

* 5+ years in Revenue Integrity, Revenue Cycle, or workflow optimization

* 5+ years of leadership experience

* Epic Resolute (HB/PB) experience

* Advanced knowledge of CPT/HCPCS, revenue codes, CMS billing regulations, NCCI/MUE edits, charge capture, and payer reimbursement

* Advanced proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook), including advanced Excel skills for data analysis and reporting

Preferred Qualifications

* CPC, CCS, RHIA, RHIT, CRCR or similar certification

* Epic HB or PB certification

* Experience leading a team through charge optimization initiatives in an integrated health system

* Knowledge of payer contracts and reimbursement methodologies

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:

$86,902.40 - $

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 .