Strength Through Diversity
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Dept- Patient Financial Services
Job Title: Reimbursement/Chargemaster Analyst
The Reimbursement and Chargemaster Analyst is responsible for maintaining charge description master including updates, setting new charges, reviewing for compliance, and making recommendations for optimizing reimbursement as well as maintaining competitive pricing. This individual works closely with hospital departments to ensure charges are compliant according to all applicable regulations and billing requirements.
- Responsible for reviewing and maintaining CDM especially for supplies and drugs, ensuring all data elements are accurate and comply with all payors requirements
- Recommends appropriate charge structure for CDM items
- Reviews area charge description master with departments on a quarterly or as needed basis
- Works with the revenue producing departments to ensure ongoing coordinated consistency of CDM, including accurate descriptions, coding, additions, deletions, pricing and any other changes. Additionally, is responsible for converting HCPCS units, as necessary
- Ensures that all Chargemaster changes are appropriately communicated to affected departments and modifications made in related ancillary systems.
- Analyzes charges and reimbursement to ensure compliance with Federal and State claims submission regulations
- Ensures the existence of accurate charging processes
- Participates in ongoing coordination and resolution of revenue issues as they arise
- Monitors charge sheets and systems used by revenue producing departments to verify that they are current and accurate. In cooperation with departmental managers, designs new charge sheets as necessary.
- Represents Chargemaster issues and concerns on the various Epic design/testing/upgrade teams and committees.
- Manages and Conducts special project reviews
- Other duties as assigned
- Bachelor’s degree in health administration, health information, management or business administration
- 3-5+ years experience in areas of hospital billing, coding, and reimbursement, preferably as CDM coordinator, revenue cycle analyst or coding consultant is preferred. Nursing or clinical or materials management/purchasing background is a plus.
- Understanding of CPTs, HCPCS, APCs, and OPPS preferred
- Excellent analytical, problem solving, and interpersonal and communication skills.
- Must have strong understanding of Medicare, Medicaid and third party payor rules and regulations and thorough knowledge of UB-92 data element requirements.