Revenue Integrity Chargemaster Analyst

Kootenai Health • Coeur d'Alene, ID

7d • Remote

About The Position

The Revenue Integrity Chargemaster Analyst maintains the integrity of the Chargemaster (CDM), ensuring charging information—including pricing, HCPCS/CPT codes and descriptions, and revenue codes—is current and compliant with payer requirements, government regulations, and industry standards. In partnership with the director and controller, the analyst serves as the organization’s primary Chargemaster subject matter expert for annual pricing reviews, analysis, and recommendations, and ensures annual updates are published in accordance with federal price transparency regulations.

The position supports hospital and professional charging across the organization through CDM development, maintenance, reimbursement analysis, audits, reporting, pricing recommendations, and coordination with clinical departments, IT, compliance, and leadership. The role is remote eligible and involves typical office equipment and maintaining a sitting position.

Requirements

• Bachelor’s degree in a related field, or six years of directly related Revenue Integrity experience may be accepted in lieu of the degree.
• Experience in physician (professional) and hospital financial or revenue cycle operations.
• Demonstrated knowledge of CMS regulations governing hospital and professional coding and billing.
• Ability to collaborate in interdisciplinary workgroups and build effective working relationships with staff and leadership at all levels.
• Ability to manage multiple priorities and meet established project deadlines.

Nice To Haves

• Two years of responsible Chargemaster (CDM and fee schedule) experience preferred.
• AAPC or AHIMA coding certification preferred.
• Completion of a medical terminology class preferred.
• Experience working in Epic or a similar EMR with equivalent applications preferred.
• Previous process improvement experience preferred.

Responsibilities

• Develop and maintain the charge description master and conduct comparative reimbursement analysis for hospital and professional charging across the organization.
• Review and initiate CDM changes, additions, and deletions, overseeing others’ work as necessary.
• Ensure the accuracy of clinical charges, descriptions, and billing codes in the Chargemaster.
• Lead hospital departments and IT staff in formulating strategies for an efficient, compliant Chargemaster across software applications.
• Prepare the organization for timely annual coding updates, including CPT and HCPCS updates, modifier revisions, and regulatory updates related to Chargemaster data.
• Create internal policies, procedures, tools, and forms for Chargemaster maintenance.
• Compile and analyze clinical, competitor, payer charge, and reimbursement data to prepare pricing and charging recommendations; present recommendations to leadership as requested.
• Prepare regular CDM and payer reimbursement reports based on charge patterns and proposed CDM changes.
• Monitor organizational charging and billing patterns and ensure accurate crosswalks between Chargemaster details and clinical systems used for charge capture and clinical documentation.
• Conduct quarterly CDM audits to support the accuracy and quality of hospital revenue.
• Hold periodic meetings with departments to review error reports, audit information, and regulatory changes; facilitate meetings and document questions, issues, and follow-up tasks.
• Implement corrections, resolve outstanding issues, and escalate issues to leadership as needed.
• Monitor CDM maintenance and updates for compliance with price transparency requirements.
• Monitor compliance initiatives related to Chargemaster data in collaboration with the Compliance Officer, including investigatory activities and published findings that may correlate with billed data.
• Develop pricing recommendations for new CDM items and services using research on local peer groups and other appropriate hospitals.
• Manage multiple priorities and meet established project deadlines.
• Perform other related duties as assigned.
• Maintain high productivity and quality with minimal supervision, using experience and judgment to plan and accomplish goals.
• Maintain regular and predictable attendance.
• Meet the age-specific needs of the assigned unit.

Benefits

• Comprehensive medical coverage, including fully employer-paid options for eligible full-time employees and affordable plans for part-time staff.
• Dental, vision, life, and pet insurance.
• Telemedicine and wellbeing resources.
• Tuition assistance after 90 days.
• Retirement plans with pre-tax and Roth options and employer matching from 3% to 6%.
• Competitive pay, plus night, weekend, and PRN shift differentials.
• Award-winning wellness program with coaching, financial wellness resources, and free or discounted access to fitness centers and premium wellbeing apps.
• PerkSpot discounts with deals in over 25 categories.
• Employee referral bonus program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level