The Revenue Integrity Analyst is responsible for maintaining El Camino Health’s Charge Description Master (CDM) and supporting broader revenue integrity functions across the organization. The role ensures accurate charge capture and billing through coding expertise, documentation review, and compliance with CMS and commercial payer requirements.
This position also supports clinical departments in resolving NCCI and MUE denials, reviews supporting documentation in the EHR, advises on billing modifiers and corrections, and collaborates with clinical stakeholders, IT, and Revenue Cycle teams to ensure compliant and complete revenue capture.
Qualifications
- High school diploma or equivalent required; bachelor’s degree in business, Health Information Management (HIM), or a healthcare-related field preferred
- 3 years of combined experience in hospital CDM management, charge capture, or revenue integrity roles
- Minimum 2 years of experience with professional or facility coding, modifier usage, and claim edit resolution
- Experience interpreting clinical documentation in the EHR and applying coding principles to support accurate billing
- Proficient in Microsoft Excel, Word, and Epic or comparable EHR/CDM systems
- Strong understanding of the hospital revenue cycle
- Excellent communication and interpersonal skills with the ability to work across all levels of the organization
- Highly collaborative and able to work effectively in a dynamic team environment
Certification
- Required: Certified Professional Coder (CPC) from AAPC
- Preferred: Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician-based (CCS-P) from AHIMA
- Must maintain active certification status in good standing throughout employment
Location
California, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago