The Revenue Integrity Analyst is responsible for maintaining El Camino Health’s Charge Description Master (CDM) while also supporting broader revenue integrity functions across the organization.
This position ensures accurate charge capture and billing by providing subject matter expertise in coding, documentation review, and compliance with CMS and commercial payer requirements.
In addition to traditional CDM maintenance duties, this role supports clinical departments in resolving NCCI and MUE denials, reviews supporting documentation in the electronic health record, and advises on billing modifiers and corrections.
The analyst collaborates with clinical stakeholders, IT, and Revenue Cycle departments to ensure compliant and complete revenue capture.
Maintain the CDM, including CPT/HCPCS coding, UB-04 revenue code assignment, and pricing. Oversee professional fee schedules for hospital-affiliated clinics. Ensure CDM compliance with updates from CMS, AMA, and other payers. Review and resolve NCCI and MUE edits with coding, clinical, and billing teams. Interpret clinical documentation in the EHR to validate charges and resolve coding discrepancies. Provide education and guidance on accurate, compliant charge capture practices. Support audits and charge validations to identify revenue recovery and compliance opportunities. Collaborate with IT and application teams to integrate CDM changes into charge capture workflows. Monitor regulatory and payer guidance to maintain CDM accuracy and reduce denials.
Location
California, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago