Revenue Integrity Charge Analyst

Responsibilities

• Educate employees, clinical departments, and provider offices on correct claim coding, including CPT, ICD-9, ICD-10, and HCPCS.
• Assign pricing and ensure pricing aligns with CDM methodology.
• Resolve billing edits requiring HCPCS/CPT coding that are delaying claim processing.
• Support implementation of coding and pricing updates, revenue code updates, modifier revisions, and regulatory updates.
• Serve as a chargemaster liaison for clinical department education and charge-related issue resolution.
• Review annual CPT/diagnosis/HCPCS changes and prepare specialty-specific educational materials.
• Support documentation template development and accurate CPT/diagnosis code assignment.
• Analyze billing errors, denials, claim rejections, and root causes.
• Collaborate with other departments to ensure proper CDM line-item charges and billing data are placed on claims.
• Help clear suspended charges, follow up on out-of-bounds charges, and identify missing charges.
• Assist with new supply charges and Optum database cleanup.
• Use Microsoft Excel effectively.

Qualifications

• Associate degree in business or a related field and 3 years of experience in revenue integrity operations, clinical charge capture, chargemaster, or revenue cycle operations.
• Bachelor's degree preferred.
• Experience with chargemaster and professional or hospital billing preferred.
• Preferred certifications include CPC, COC, CCA, CCS, or RHIT.
• Equivalent combinations of education and experience may be considered.

Employees in regular positions working 20 hours or more per week (.50 FTE or greater) qualify for benefits.