Sr. Rev Integrity Charge Description Master Analyst

Adventist Health

  • Roseville, CA
  • Permanent
  • Full-time
  • 17 days ago
Job Category: AnalystJob Description:Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive cardiology care and a vast scope of services located in the San Fernando Valley. We are committed to the development and empowerment of our nurses and have received Magnet designation from the American Nurses Credentialing Center. Glendale is known for its urban living, with easy access to dining, entertainment, shopping, amusement parks and outdoor recreation. Adventist Health Glendale is proud to be part of the thriving, diverse community since 1905.Job Summary:Maintains and optimizes the organization's charge description master (CDM) to ensure accurate and compliant charging, billing, and reimbursement across all service lines for the entire health system. Supports revenue integrity efforts by analyzing, auditing, providing training, and updating charge items in alignment with payer requirements, regulatory guidelines, and clinical operations. Serves as a key liaison between clinical departments, finance, IT, compliance, and revenue cycle teams. Supports defensible pricing strategies and ongoing maintenance of prices and will support assigned standard values to ensure overall standards across the enterprise. Supports ongoing review and maintenance of other standard values, such as health plan payor master, admission types.Job Requirements:Education and Work Experience:
  • Associate's/Technical Degree or equivalent combination of education/related experience: Required
  • Bachelor's Degree: Preferred
  • Five years' of experience working in a hospital setting experience with charge-description-master (CDM) principles and the relationship to coding, billing, and compliance: Preferred
  • Epic experience: Required
Licenses/Certifications:
  • Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) or Certified Professional Coder (CPC): Required
  • Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) or Certified Professional Coder (CPC): Required
Essential Functions:
  • Maintains and updates the CDM to ensure accuracy, completeness, and compliance with current coding and regulatory standards (e.g., CPT/HCPCS, revenue codes) and alternate code logic. Monitors and interprets payer updates, coding changes, and regulatory guidance (e.g., CMS, Medicare, Medicaid) to support timely CDM and charge/claim logic updates. Ensures accurate GL cost center revenue routing. Conducts regular charge capture audits to identify discrepancies (e.g., missing, or duplicate charges) and implement corrective actions. Collaborates with clinical departments to validate that charges accurately reflect services rendered and align with documentation and coding standards.
  • Partners with IT and EHR/EMR teams (e.g., Epic, Cerner) to oversee/maintain charging related edits, proper CDM integration and system configuration. Supports, oversees and monitors revenue/charging work-queue (WQs) to ensure all charges are captured/reviewed timely and address/escalate as necessary adherence to policies. Supports development and implementation of charge capture workflows and training materials for clinical and operational staff. Develops, delivers, and revises integrity education and training programs in coordination with clinical and revenue cycle leaders.
  • Generates reports and conduct data analysis to support revenue integrity, charge reconciliation, and prevent revenue leakage. Supports month-end and year-end close processes related to charge integrity. Participates in new service line or department implementations to ensure accurate charging structures and CDM setup. Analyzes charge codes to identify inconsistencies and improvement opportunities.
  • Ensures all charging policies and procedures comply with federal, state, and third-party payer billing guidelines. Supports strategies to improve revenue cycle performance and reduce leakage. Collaborates with coding, billing, and clinical teams to maintain compliant and accurate charging practices. Supports projects that enhance charging accuracy and support integration of third-party tools.
  • Ensures compliance with price transparency and related regulatory requirements. Monitors key performance indicators (KPIs) to identify trends, track improvements, and guide performance initiatives. Maintains up-to-date knowledge of applicable billing and reimbursement regulations. Supports approval and ongoing maintenance of application master standard values.
  • Performs other job-related duties as assigned.
Organizational Requirements:Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.About Us: Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

Adventist Health