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

About Kootenai Health

Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.

As your next employer, we are excited to offer you:

• Comprehensive medical coverage, including fully employer‑paid options for eligible full‑time employees, plus affordable plans for part‑time staff. Benefits begin on the 1st of the month following 30 days of employment.
• Dental, vision, life, and pet insurance, with telemedicine and wellbeing resources available to all employees
• Tuition assistance after 90 days to support your professional growth
• Retirement plans with pre‑tax and Roth options and employer matching from 3%–6%
• Competitive pay, plus night, weekend, and PRN shift differentials
• Award‑winning wellness program with coaching, financial wellness resources, and free or discounted access to fitness centers and premium wellbeing apps
• PerkSpot discounts providing access to thousands of exclusive deals in over 25 categories
• And an employee referral bonus program

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!

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.