Pediatric Revenue Integrity Lead

Children's National Hospital; Silver Spring (MD); On-site; USD 78,000 - 129,000; Full time

Job summary

Children's National Hospital is seeking a Senior Revenue Integrity Analyst in Silver Spring, MD to oversee charge workflows, billing compliance, and charge analysis in a pediatric setting. The role supports accurate CPT/HCPCS coding and pricing practices, driving compliant revenue across hospital and professional services.

Responsibilities include reviewing charge master workflows, providing education to departments, and assisting clinical management with CDM changes, while ensuring adherence to

Qualifications

• Associate's Degree; relevant experience may substitute the educational requirement on a 1-to-1 ratio.
• Bachelor's Degree in Healthcare related field preferred.
• 4 years experience in charge capture, coding or charge description master in a hospital environment for hospital and professional services.
• Demonstrates excellent organizational and problem solving skills.
• Ability to delegate assignments and follow through on details is essential.
• Excellent internal and external customer service skills in a fast-paced environment.

Responsibilities

• Validate and approve access to all charge workflows and charge corrections, as directed by the CDM Supervisor.
• Provide education and in-service training to departments in collaboration with CDM Supervisor.
• Provide assistance and analysis to all levels of clinical management in support of changes to the CDM.
• Process complex CDM requests to ensure additions/changes/deletions are compliant.
• Conduct annual review of the charge master and quarterly updates to enhance revenue.
• Analyze data within the CDM and assign CPT/HCPCS and revenue codes to ensure regulatory compliance.
• Distribute coding and billing regulatory requirements to applicable departments.
• Lead special projects as directed by the CDM Supervisor.
• Monitor and report all revenue department charge volumes and posting lag days.
• Research and resolve all charge and service master related code errors.

Skills

Charge capture

Coding

Billing compliance

Problem solving

Organizational skills

Communication

Education

Associate's Degree

Bachelor's Degree in Healthcare

Tools

CPT/HCPCS coding

Job description

Children's National Hospital is seeking a Senior Revenue Integrity Analyst in Silver Spring, MD to oversee charge workflows, billing compliance, and charge analysis in a pediatric setting. The role supports accurate CPT/HCPCS coding and pricing practices, driving compliant revenue across hospital and professional services.

Responsibilities include reviewing charge master workflows, providing education to departments, and assisting clinical management with CDM changes, while ensuring adherence to