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Revenue Integrity Manager - Charge Optimization

Remote · Australia Full-time

Building Location: Business Service Center Department: 1006210 REVENUE INTEGRITY - EH SS Job Description: The Revenue Integrity Manager provides strategic leadership for enterprise-wide charge governance, revenue optimization, and Epic revenue cycle configuration across the entire integrated health system. This role oversees Revenue Cycle team members responsible for charge build integrity, chargemaster (CDM) governance, reconciliation controls, denial prevention, system optimization, and regulatory compliance. The Manager ensures that Epic configuration, charging workflows, and CDM structure support compliant, accurate, and timely billing while minimizing revenue leakage and audit risk. This position partners closely with Finance, Coding, Compliance, Patient Access, Billing, Clinical Operations, Informatics, and IT to align system design with financial strategy. Education Qualifications: Key Responsibilities: Lead enterprise Revenue Integrity strategy and operational execution Establish governance for charge build, CDM maintenance, reconciliation controls, charge capture, and denial prevention Ensure CDM standardization, pricing integrity, and regulatory update implementation Promote automation to reduce manual work queues and improve reconciliation efficiency Maintain compliance with CMS, NCCI, MUE, OPPS/IPPS, and price transparency regulations Ensure enterprise charge reconciliation processes and internal controls are in place and monitored Drive continuous improvement initiatives to reduce revenue leakage Educate operational leaders on charge governance, reconciliation expectations, and regulatory risk Manage, mentor, lead team members and serve as escalation point for high-risk revenue cycle issues Education Requirement: Bachelor's degree in Healthcare Administration, Finance, Business, or a related field preferred. Candidates with relevant professional experience in lieu of a degree may also be considered. Required Qualifications: 5+ years in Revenue Integrity, Revenue Cycle, Charge Build, CDM governance, or Healthcare Finance 5+ years of leadership experience Experience with Epic Resolute (HB/PB) 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 standardization 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 - $130,353.60 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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