Revenue Integrity and Chargemaster Analyst

Title: Revenue Integrity and Chargemaster Analyst (FT- 1.0 FTE, Day Shift, Remote)

Location: USA - Arizona, Florida, Georgia, Idaho, Iowa, South Dakota, Texas, South Carolina, Wisconsin, North Carolina, Michigan 

Job Description:

time type

Full time

job requisition id

R12844

This position can be remote. Please review the approved remote states below. 

Remote Work Approved States:
Arizona
Florida
Georgia
Idaho
Iowa
South Dakota
Texas
South Carolina
Wisconsin
North Carolina
Michigan 

*If your state is not listed, you must relocate to Montana or one of the approved states above to be eligible for this position.

Position Summary: 

The Revenue Integrity and Chargemaster Analyst maintains the integrity of the Charge Description Master (CDM) and supports compliant, accurate charge capture processes across the health system. The role collaborates with clinical departments, coding, billing, compliance, and IT to ensure services, procedures, and supplies are appropriately documented, coded, and billed in accordance with payer requirements and regulatory standards. The analyst also supports charge capture audits, reimbursement analysis, pricing reviews, and revenue optimization initiatives.

Minimum Qualifications:

Required

• Associate’s Degree; or an equivalent combination of education and experience may be considered.
• Two (2) years of experience in revenue integrity, CDM maintenance, coding, or billing.
• Advanced understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), revenue codes, modifiers, and healthcare billing principles.
• Intermediate knowledge of EPIC billing system, charge capture tools, and regulatory resources (e.g., Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), Outpatient Prospective Payment System (OPPS)).
• Intermediate knowledge of billing requirements for OPPS, Critical Access Hospital (CAH), and Prospective Payment System (PPS) settings, including Uniform Billing Form (UB-04) and CMS guidelines for hospital billing (HB), professional billing (PB), and provider-based billing (PBB).

Preferred

• Bachelor’s Degree in Health Information Management, Business, Finance, or a related field.
• Four (4) years of experience in revenue integrity, CDM maintenance, coding, or billing.
• Prior experience in a hospital or health system.
• Professional certification such as Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Representative (CRCR), or Certification in Healthcare Revenue Integrity (CHRI).
• Experience with Epic Resolute HB/PB charge build (EAP records), charge router rules, and fee schedule maintenance.
• Experience supporting internal or external payer audits and implementing corrective action plans.

Essential Job Functions:

In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

• Maintain the Charge Description Master (CDM), ensuring all CPT/HCPCS codes, revenue codes, pricing, modifiers, and descriptions are accurate and updated based on quarterly and annual regulatory changes.
• Collaborate with clinical departments and service line leaders to evaluate requests for new charge codes, price changes, or service modifications.
• Conduct ongoing charge capture audits to identify missed charges, billing errors, and compliance risks; escalate findings and partner with departments on corrective actions and prevention.
• Review and interpret payer guidelines, National Correct Coding Initiative (NCCI) edits, Medically Unlikely Edits (MUEs), OPPS regulations, and Medicare/Medicaid bulletins to ensure a compliant charge structure.
• Support the implementation of new services or technologies by facilitating charge build, revenue code assignment, and mapping to billing workflows.
• Provide analytical support for revenue variance investigations, reimbursement trends, charge validation, and payer audit responses; summarize and present findings to stakeholders.
• Assist in validating the accuracy of chargemaster pricing relative to CMS fee schedules, organizational pricing strategies, and applicable price transparency requirements.
• Participate in revenue cycle performance improvement initiatives related to charge capture, reconciliation, and clean claim submission; document root causes and monitor outcomes.
• Collaborate with IT and billing teams to test charge router rules, EAP builds, and fee schedule updates within the billing system.
• Maintain clear, organized records of CDM changes, audit findings, and billing guidance to support accuracy, compliance, and audit readiness.
• Educate departments and end users on charge capture requirements, documentation standards, and changes affecting charging, coding, and billing.
• Participate in or support cross functional revenue integrity/charge governance meetings and committees.

Knowledge, Skills, and Abilities

• Demonstrates sound judgment, patience, and maintains a professional demeanor at all times.
• Exercises tact, discretion, sensitivity, and maintains confidentiality.
• Performs essential job functions successfully in a busy and stressful environment.
• Learns current and new computer applications and office equipment utilized at Bozeman Health.
• Strong interpersonal, verbal, and written communication skills.
• Analyzes, organizes, and prioritizes work while meeting multiple deadlines.

Schedule Requirements

• This role requires regular and sustained attendance.
• The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
• On-call work may be required to respond promptly to organizational, patient, or employee needs.

Physical Requirements

• Lifting (Rarely – 30 pounds): Exerting force and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.
• Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination.
• Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.
• Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints.
• Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.
• Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.
• Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
• Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
• Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.
• Exposures (Rarely): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses.

*Frequency Key: Continuously (100% - 67% of the time), Repeatedly (66% - 33% of the time), Occasionally (32% - 4% of the time), Rarely (3% - 1% of the time), Never (0%).

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification.  They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified.