CPC-Certified Revenue Integrity Analyst

El Camino Health; Mountain View (CA); On-site; USD 68,000 - 102,000; Full time

Job summary

El Camino Health in Mountain View, CA is seeking a Revenue Integrity Analyst to maintain the CDM and support broader revenue integrity. You will ensure accurate charge capture, review coding in the EHR, and collaborate with IT and clinical teams to anticipate payer changes and minimize denials.

The role requires CPC certification or equivalent, a strong understanding of CMS and payer requirements, and experience with EPIC/EHR systems.

Qualifications

• High School Diploma or equivalent.
• Bachelor’s degree in business, HIM, or Healthcare-related field preferred.
• 3 years of combined experience in hospital CDM management, charge capture, or revenue integrity roles.
• Minimum two years’ experience with professional or facility coding, modifier usage, and claim edit resolution.
• Experience interpreting clinical documentation in the EHR and applying coding principles to support accurate billing.
• Proficient in Microsoft Excel, Word, and Epic (or comparable EHR/CDM systems).
• Highly collaborative and able to work cohesively in a dynamic team environment.
• Strong understanding of hospital’s comprehensive revenue cycle.
• Strong communication and interpersonal skills; able to work well with all levels in the organization, including Senior Leadership.

Responsibilities

• Maintain CDM for all required elements, including but not limited to assignment of applicable CPT/HCPCS coding, UB-04 Revenue Codes, and appropriate pricing.
• Maintain and oversee professional fee schedules for hospital-affiliated clinics.
• Ensure that El Camino Health’s CDM remains compliant with changing billing and coding updates made by CMS, AMA and other payers.
• Review and resolve NCCI and MUE edits in collaboration with coding, clinical, and billing teams, determining appropriate modifier usage and correction strategies based on documentation.
• Read and interpret clinical documentation in the EHR to validate submitted charges and support resolution of coding discrepancies.
• Partner with clinical and ancillary departments to provide education, direction, and guidance on accurate and compliant charge capture practices.
• Support audits and charge validations to identify opportunities for revenue recovery and compliance improvement.
• Collaborate with IT and application teams (e.g., Epic) to ensure CDM changes are integrated with front-end charge capture tools and workflows.
• Monitor regulatory changes and payer guidance to proactively maintain CDM accuracy and minimize claim denials related to coding or documentation issues.

Skills

CDM management

Charge capture

Revenue integrity

Epic usage

Education

High School Diploma or equivalent

Bachelor’s degree in business, HIM, or Healthcare-related field preferred

Tools

Epic

Microsoft Excel

Microsoft Word

Job description

El Camino Health in Mountain View, CA is seeking a Revenue Integrity Analyst to maintain the CDM and support broader revenue integrity. You will ensure accurate charge capture, review coding in the EHR, and collaborate with IT and clinical teams to anticipate payer changes and minimize denials.

The role requires CPC certification or equivalent, a strong understanding of CMS and payer requirements, and experience with EPIC/EHR systems.