Revenue Integrity Chargemaster Lead

Revenue Integrity Chargemaster Lead Job Code:

29329 Position Summary The Revenue Integrity Chargemaster Lead oversees the integrity, strategy, and ongoing governance of the Chargemaster, ensuring all pricing, HCPCS/CPT codes, descriptions, and revenue codes remain accurate, current, and compliant with payer, regulatory, and organizational requirements. Serves as the primary lead for the CDM development and implementation for all new service lines, partnering with operational, clinical, and financial stakeholders to ensure accurate and compliant charge structures from inception. Ensures the CDM is built and maintained in accordance with federal and industry regulations. Collaborates with Revenue Integrity Director as the organization's primary subject matter expert for the Chargemaster, leading annual pricing reviews, conducting financial and compliance analyses, and developing pricing update recommendations. Ensures timely publication of annual pricing updates to support compliance with federal prices transparency mandates and organizational revenue integrity goals. Responsibilities Leads the overall development, integrity, and governance of the Chargemaster, ensuring all pricing, HCPCS/CPT codes, revenue codes, and charge descriptions remain accurate, compliant, and aligned with organizational strategy Oversees all CDM changes, additions, and deletions; ensures timely implementation of annual

CPT/HCPCS

updates, modifier revisions, and regulatory changes; maintains compliance with federal price transparency and payer requirements Serves as the primary lead for designing, building, and implanting CDM structures for all new service lines, collaborating with clinical, operational, and IT teams to ensure accurate and compliant charge capture from inception Provides workload prioritization for CDM analysts; establishes internal policies, procedures, tools, and documentation standards to support consistent and high-quality CDM operations Conducts comparative reimbursement analysis, competitive pricing research, and payer charge modeling; prepares pricing recommendations for new and existing services; presents findings to leadership to support revenue integrity and strategic pricing decisions Monitors organizational charging patterns, validates crosswalks between the CDM and clinical/IT systems, and ensures accurate mapping to support compliant charge capture and documentation workflows Leads CDM audits, reviews error reports, analyzes audit findings, and partners with departments to resolve discrepancies; escalates systemic issues to leadership and ensures corrective actions are implemented Collaborates with Compliance, Revenue Integrity, and operational leaders to monitor investigatory findings, ensure adherence to regulatory standards, and prepare routine CDM and reimbursement reports that support transparency and organizational decision-making Relies on experience and judgment to plan and accomplish goals Regular and predictable attendance is an essential job function Performs other related duties as assigned Competent to meet age-specific needs of the unit assigned Requirements and Minimum Qualifications High school diploma or equivalent required Bachelors degree in related field required; Minimum 6 years' directly related experience in a CDM role may be accepted in lieu of degree

CHFP, CRCR

certification preferred Minimum 5 years' of responsible CMD (Chargemaster and fee schedule) experience required Experience in the healthcare industry (business office, finance, revenue auditing, coding, etc.) Extensive familiarity with CPT and HCPCs charge codes Knowledge of the dynamics of charge accuracy programs Strong computer skills including working knowledge of Excel and Word, ability to adapt quickly to new systems and tools Strong knowledge of hospital and clinics billing requirements, billing systems, payer contract parameters, proration protocols Demonstrated experience with process improvement strategies and the development of effective workflows Working Conditions Must be able to lift and move up to 10 lbs Must be able to maintain a sitting position Must be able to communicate and exchange accurate information Typical equipment used in an office job Remote eligible As your next employer, we are excited to offer you: Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1st of the month following 30 days of employment. Kootenai Health's tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent. Competitive salaries with night, weekend, and PRN shift differentials An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching Employees receive discounts at The Wellness Bar, PEAK Fitness, and more Robust and interactive employee referral program And much more Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Please contact the HR Front Desk at 208-625-4620 or email careers@kh.org with any questions. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex. #KHHP25

Location:

Kootenai Health • Revenue Cycle -

Revenue Integrity Schedule:

Full Time, Days