Revenue Integrity Analyst

The Revenue Integrity Analyst is responsible for coordinating the hospital charge master system and maintaining a complete, accurate, and standardized charge master. The role supports clinical and administrative departments with charge master expertise, education, guidance, and recommendations to help optimize net revenue.

Department

Revenue Integrity

Core Responsibilities

• Provide education and in-service training to departments.
• Analyze and support requested or mandated changes to the charge description master (CDM).
• Process CDM requests to ensure additions, changes, and deletions align with proper charging, billing, coding, and pricing practices.
• Conduct annual charge master reviews and quarterly updates to enhance hospital revenue.
• Analyze CDM data and assign accurate CPT/HCPCS and revenue codes to ensure regulatory compliance.
• Distribute coding and billing regulatory updates to applicable departments.
• Make CDM-related decisions requiring significant analysis and investigation.
• Develop and maintain policies and procedures for CDM, pricing policies, and charge capture processes.
• Maintain the Charge Description and Service Master and Room and Bed Master files.
• Create and maintain hospital transaction codes and revenue department codes.
• Monitor and report charge volumes and posting lag days.
• Research and resolve charge and service master code errors affecting recycle and reject reports.
• Support comprehensive departmental reviews to ensure CDM completeness and accuracy.
• Identify system or operational problems and help develop solutions to improve billing functions.
• Serve as a resource for code and processing questions and train coders.
• Act as a liaison to department administration, physicians, clinic administration, information services, billing offices, financial offices, and other departments.
• Lead special projects and assignments.
• Follow safety practices and maintain accurate, clear, and timely communication.