Revenue Integrity and Chargemaster Analyst (FT- 1.0 FTE, Day Shift, Remote)

Bozeman Health

1d•Remote

About The Position

The Revenue Integrity and Chargemaster Analyst maintains the integrity of the Charge Description Master (CDM) and supports compliant, accurate charge capture processes across the health system. The role collaborates with clinical departments, coding, billing, compliance, and IT to ensure services, procedures, and supplies are appropriately documented, coded, and billed in accordance with payer requirements and regulatory standards. The analyst also supports charge capture audits, reimbursement analysis, pricing reviews, and revenue optimization initiatives.

Requirements

Associate’s Degree; or an equivalent combination of education and experience may be considered.
Two (2) years of experience in revenue integrity, CDM maintenance, coding, or billing.
Advanced understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), revenue codes, modifiers, and healthcare billing principles.
Intermediate knowledge of EPIC billing system, charge capture tools, and regulatory resources (e.g., Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), Outpatient Prospective Payment System (OPPS)).
Intermediate knowledge of billing requirements for OPPS, Critical Access Hospital (CAH), and Prospective Payment System (PPS) settings, including Uniform Billing Form (UB-04) and CMS guidelines for hospital billing (HB), professional billing (PB), and provider-based billing (PBB).

Nice To Haves

Bachelor’s Degree in Health Information Management, Business, Finance, or a related field.
Four (4) years of experience in revenue integrity, CDM maintenance, coding, or billing.
Prior experience in a hospital or health system.
Professional certification such as Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Representative (CRCR), or Certification in Healthcare Revenue Integrity (CHRI).
Experience with Epic Resolute HB/PB charge build (EAP records), charge router rules, and fee schedule maintenance.
Experience supporting internal or external payer audits and implementing corrective action plans.

Responsibilities

Maintain the Charge Description Master (CDM), ensuring all CPT/HCPCS codes, revenue codes, pricing, modifiers, and descriptions are accurate and updated based on quarterly and annual regulatory changes.
Collaborate with clinical departments and service line leaders to evaluate requests for new charge codes, price changes, or service modifications.
Conduct ongoing charge capture audits to identify missed charges, billing errors, and compliance risks; escalate findings and partner with departments on corrective actions and prevention.
Review and interpret payer guidelines, National Correct Coding Initiative (NCCI) edits, Medically Unlikely Edits (MUEs), OPPS regulations, and Medicare/Medicaid bulletins to ensure a compliant charge structure.
Support the implementation of new services or technologies by facilitating charge build, revenue code assignment, and mapping to billing workflows.
Provide analytical support for revenue variance investigations, reimbursement trends, charge validation, and payer audit responses; summarize and present findings to stakeholders.
Assist in validating the accuracy of chargemaster pricing relative to CMS fee schedules, organizational pricing strategies, and applicable price transparency requirements.
Participate in revenue cycle performance improvement initiatives related to charge capture, reconciliation, and clean claim submission; document root causes and monitor outcomes.
Collaborate with IT and billing teams to test charge router rules, EAP builds, and fee schedule updates within the billing system.
Maintain clear, organized records of CDM changes, audit findings, and billing guidance to support accuracy, compliance, and audit readiness.
Educate departments and end users on charge capture requirements, documentation standards, and changes affecting charging, coding, and billing.
Participate in or support cross functional revenue integrity/charge governance meetings and committees.