Revenue Integrity & Chargemaster Coordinator - Patient Business Services

Revenue Integrity & Chargemaster Coordinator

Under the leadership of the Director, the Revenue Integrity & Chargemaster Coordinator is responsible for managing organization-wide activities necessary for the development, maintenance, governance, editing, and updating of the Charge Description Master (CDM). This position is accountable for ensuring the validity, accuracy, compliance, and integrity of the organization's pricing structure, charge descriptions, CPT/HCPCS coding, revenue codes, and associated billing elements required for reimbursement from government, commercial, and patient pay sources.

The coordinator is responsible for ensuring the Charge Description Master withstands scrutiny from Finance, Patient Business Services, Health Information Management (HIM), Compliance, Internal Audit, regulatory agencies, third-party payers, and external auditors. The position may coordinate with external consultants and vendors to ensure alignment with regulatory requirements, industry standards, payer expectations, and revenue integrity best practices. Consistent with current responsibilities, the role may also support organization-wide Revenue Integrity assessments, chargemaster audits, pricing reviews, and charge capture improvement initiatives. The position works collaboratively with leadership, managers, clinical departments, Finance, HIM, Compliance, Internal Audit, Patient Access, Patient Financial Services, Revenue Cycle, and Information Technology to ensure accurate and compliant charging practices, appropriate coding structure, accurate pricing methodologies, and effective charge capture processes throughout the organization.

The coordinator serves as the organizational subject matter expert for Charge Description Master governance, revenue integrity, pricing transparency, charge capture compliance, operational charging workflows, and revenue optimization strategies. This position serves as a consultative resource to clinical and operational departments by analyzing charge capture practices, identifying revenue leakage opportunities, reviewing charging accuracy, evaluating operational workflows, and providing education regarding revenue cycle best practices and departmental responsibilities. The coordinator assists operational leaders in maximizing compliant reimbursement, improving charge capture performance, resolving charging issues, reducing billing errors, and strengthening accountability for revenue-producing activities.

Essential Responsibilities

• Maintain and govern the hospital Charge Description Master (CDM), including charge creation, revisions, CPT/HCPCS updates, revenue code assignments, pricing support, and annual maintenance activities.
• Perform revenue integrity audits to evaluate charge capture accuracy, reimbursement opportunities, coding consistency, and billing compliance.
• Identify and investigate revenue leakage, charging errors, missed charges, and operational workflow deficiencies impacting financial performance.
• Monitor, analyze, and support resolution of revenue-related Epic work queues, charge edits, and operational charging issues.
• Collaborate with HIM, Compliance, Finance, Patient Financial Services, Internal Audit, and clinical departments to ensure complete and compliant charge capture processes.
• Perform retrospective account reviews and provide recommendations for charge corrections, coding updates, and process improvements.
• Support organizational compliance with CMS, Medicare, Medi-Cal, pricing transparency, billing, coding, and reimbursement requirements.
• Assist with charge capture workflow design, operational process improvement, and implementation of revenue integrity best practices.
• Prepare reports, analyses, and presentations regarding revenue integrity findings, audit outcomes, financial impact, and corrective action opportunities.
• Collaborate with clinical, operational, and financial leaders to improve charge capture accountability and departmental ownership.
• Coordinate and support external consultants, auditors, and regulatory reviews involving chargemaster governance, pricing, revenue integrity, and reimbursement activities.
• Provide education and consultation regarding chargemaster structure, coding requirements, charging workflows, regulatory updates, and revenue cycle impacts.
• Participate in system implementation, Epic optimization, revenue cycle initiatives, and organization-wide revenue integrity projects.

Experience

• Required: Five or more years of progressively responsible experience in healthcare revenue cycle operations, finance, patient accounting, revenue integrity, chargemaster management, coding, reimbursement, billing, or health information management.
• Demonstrated experience with hospital Charge Description Master (CDM) management, charge capture processes, pricing methodologies, coding, reimbursement, and revenue cycle operations.
• Strong understanding of inpatient and outpatient revenue cycle workflows.
• Knowledge of Medicare, Medi-Cal, commercial payer reimbursement methodologies, and applicable regulatory requirements.
• Experience performing audits, data analysis, revenue recovery reviews, or operational process improvement initiatives.
• Experience working with clinical departments, HIM, Finance, Compliance, and operational leadership.
• Preferred: Revenue Integrity program experience.
• Epic Revenue Integrity, Charge Router, Charge Review Work queues, Resolute, and Charge Description Master experience.
• Experience supporting pricing transparency, chargemaster governance, and revenue optimization initiatives.
• Project management and process improvement experience.

Education Required: High School Diploma or GED.

Preferred: Associate's or Bachelor's Degree in Business Administration, Healthcare Administration, Health Information Management, Finance, Accounting, Nursing, or related field.

Licensure / Certifications Preferred:

• Certified Revenue Integrity Professional (CRIP)
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC)
• Certified Healthcare Financial Professional (CHFP)
• Certified Revenue Cycle Representative (CRCR)
• Other applicable Revenue Integrity, Coding, Compliance, or Healthcare Finance certifications.

Equal Opportunity Employer

Salary Range (based on years of applicable experience): $108,825 to $145,579

Assigned Work Hours: Full time (exempt), day shift

Position Type: Regular

Pay Range (based on years of applicable experience): $52.32 to $69.99