Revenue Integrity Analyst - Laboratory
Core
Maintain and update the laboratory chargemaster (CDM), conduct audits of laboratory charges and coding accuracy, and ensure compliance with federal and state regulations including Medicare guidelines.
Role type
Revenue Integrity Analyst (Laboratory)
Builds
Accurate charge capture workflows and compliant billing processes for laboratory services
Domain
Healthcare / Clinical Laboratory Operations
Required skills
CPT/HCPCS coding, chargemaster (CDM) management, medical billing, audit analysis, regulatory compliance (Medicare/NCCI), data analysis (Excel), stakeholder collaboration
Preferred skills
Experience as a medical technologist, knowledge of LIS/EHR systems, contract pricing review
Technologies
LIS, EHR, Excel
Responsibilities
Maintain and update the laboratory chargemaster (CDM) with accurate codes and pricing; Conduct routine audits of laboratory charges to identify errors or compliance risks; Review denials and reimbursement trends to recommend corrective actions; Partner with laboratory leadership, billing, and IT to support accurate charge capture; Develop documentation and reports on charge accuracy and denial trends; Provide training to staff on coding and billing requirements.
Seniority
Individual Contributor