Employment Status: Full-Time (.75 or greater)
Hours per Pay Period: 1.00 = 80 hours (Non-Exempt)
Starting Wage DOE: 18.95 - 24.44
Under general guidance, responsible for the continual maintenance, analysis, development, and improvement of the charge (fee) schedules of the organization. Completes assignments of a broad nature independently, for the Director of Reimbursement, or collectively with other Financial Support staff.
Essential Job Functions
* Interacts with management, Patient Accounts, Coding, Coding Advisors and other analysts in the development of the policies and procedures necessary to ensure optimal organizational charge structure.
* Provides continued maintenance and updating of the organization's charge coding and prices in system master files. Establishes new charge pricing and coding in the master files as necessary, ensuring that new codes and updates to codes or charges are entered in a timely fashion to allow for prompt billing and reimbursement optimization.
* Assists the revenue analyst with the annual departmental fee reviews and the reviews and documentation of departmental charge processes, including system interfaces. Assists in performing analysis for annual CPT and HCPCS code updates to identify additions, deletions, and modifications. Additionally, assists in the enforcement of established fee review policies and the departmental charge and reconciliation policies and procedures.
* Develops and maintains good communication with administration, managers, specialists, and physicians.
* Acts as a resource to the health system and provides information for the appropriate individuals.
* Assists with audits of chargemaster system to assure compliance with business strategies and current policies/procedures for the billing systems used across the organization.
* Provides support in the maintenance of the other various databases within Finance, as requested. Participates in the testing and troubleshooting of system upgrades and enhancements in conjunction with Information Services and vendors.
* Participates with other Finance staff with ad hoc analysis and uses performance improvement principles to assess and improve efficiency and quality.
* Ensures that all items and services such as procedures, patient visits, supplies and pharmaceuticals that are charged through the CDM are described, coded and in compliance with billing guidelines and regulatory standards. Reviews all requests for changes, additions and deletions Validates correctness of CPT/HCPCS codes, revenue codes, and descriptions Performs routine maintenance functions in Craneware including new software releases/upgrades, merging updated CDM files, building workflows, and new user set up. Coordinates with Craneware Software Support to resolve issues to ensure that minimal downtime occurs with Craneware Chargemaster Toolkit. Assists in developing written billing guidelines and providing education and instruction in their use. Responsible for performing complex duties that must bridge an understanding of coding, finance, payer contracting and departmental functions.
* Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.
* Maintains competency in all organizational, departmental, and outside agency environmental, employee or patient safety standards relevant to job performance.
* Performs other duties as assigned or needed to meet the needs of the department/organization.
* High School diploma or equivalent.
* 2 years post-high school education, preferred.
* Prior knowledge and/or experience working with chargemaster systems and charge capture processes
* Or an equivalent combination of education and experience as it relates to the above tasks, knowledge, skills, and abilities will be considered.