Job Description

Revenue Integrity Analyst, CDM -Revenue Integrity- Corporate-Full-Time Days- Hybrid

The Revenue Integrity Analyst, Charge Description Master (CDM) for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at Mount Sinai (ISMMS) (which includes the MSHS and the Faculty Practice Plan) combines advanced financial analysis with a strong hospital healthcare revenue cycle background to ensure an accurate and compliant Chargemaster. The ideal candidate will possess knowledge of hospital charging, billing, managed care contracts, Epic workflows and quality reporting measures.

This position will report to the Director of the CDM.

Responsibilities

Chargemaster Maintenance
• Maintain and update the enterprise CDM/EAP database, including adding new charges, deleting obsolete charges, and updating descriptions, pricing, revenue codes, and HCPCS/CPT codes.
• Ensure all changes align with annual, quarterly, and ad hoc regulatory updates.
Audit and Data Integrity:
• Perform regular prospective and retrospective audits of the CDM and departmental charge capture tools to detect errors, omissions, or compliance risks.
• Supports the adherence to all Federal, State and Regulatory requirements and guidelines for the Hospital Charge Description Master.
• Supports the annual review of the hospital charge description master which includes identifying codes which have been deleted, added or replaced; assigning specific codes when appropriate; identifying description changes; and ensuring the nomenclature reflects the procedures performed.

Reporting & Analytics:
• Generate, produce, and validate standard management reports on charge capture trends, late charges, and revenue at risk.
• Analyzes hospital service charges to ensure they align with payer regulations, Medicare/Medicaid reimbursement methodologies, and managed care contracts.
• Provides routine, standardized reporting to stakeholders as requested or needed.
• Assist with development and or maintenance of reports to identify various metrics as defined by leadership or needed for departmental monitoring.
• Utilize advanced analytics to monitor revenue cycle performance and identify trends related to denials, underpayments, and coding variances.
• Create feedback loops and enhancement pipelines informed by stakeholders and data.
Pricing Strategy & Transparency
• Assist in validating CDM pricing relative to market trends, managed care contract terms, and CMS fee schedules. Support compliance with price transparency requirements.

Collaboration & Education
• Works with internal stakeholders to ensure that the Hospital CDM accurately reflects the services provided.
• Resourceful in creating or fine-tuning the processes necessary to complete the work along with the ability to organize people and activities.
• Challenge existing norms or courses of action to facilitate fully informed decision-making. Help institute balanced decision-making by identifying risks and opportunities.
• Establish and maintain strong working relationships with revenue cycle leaders, key stakeholders, and foster a strong working relationship with key strategic partners.
• Performs other duties as assigned

Qualifications

• Bachelor's degree in public health/administration, finance, business or a related field or equivalent education and experience.
• Three (3) plus years of progressively responsible experience working with the Hospital Charge Description Master, preferably in an academic medical center.
• 3-5 years with Epic Experience, Epic certification desirable.
• CPC or equivalent, a plus

Non-Bargaining Unit, 506 - Chargemaster/Projects - MSH, Mount Sinai Hospital