Charge Master Analyst

University of Arkansas for Medical Sciences•Little Rock, AR

About The Position

The Charge Master Analyst is responsible for establishing and maintaining charge capture and reconciliation processes and controls as an integral part of a multi-disciplinary Revenue Integrity team. This position acts as a liaison between clinical departments, service lines, and Revenue Cycle to ensure charging practices are compliant and achieve maximum reimbursement for hospital and professional services.

Requirements

A Bachelor's degree in business, Accounting or a related field; plus 4 years’ working with a hospital charge description master or in a hospital billing office OR a high school diploma/GED; plus 8 years’ working with a hospital charge description master or in a hospital billing office
Proficient computer skills; MS Office including Word, PowerPoint, Excel, and Outlook; Windows operating system and internet.
Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
Proficiencies – Advanced knowledge of revenue cycle processes and hospital/professional billing to include CDM, UB04, Remittance Advices and 1500 claim form.
Advanced knowledge of code data sets to include CPT, HCPCS, and ICD 10.
Advanced knowledge of NCCI edits, and Medicare LCD/NCDs.
Comprehensive understanding of reimbursement methodologies to include DRG, OPPS, professional and facility billing.
Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations.
Due to its service focus, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills, critical thinking and the ability to meet deadlines while influencing, but not directly managing the work of others.

Nice To Haves

LPN, RN, CPC, CCS, CPA
Understanding of CPT/HCPCS codes, payer regulations and payer reimbursement.
Data Visualization experience utilizing Power BI.
Working knowledge of Epic HB Resolute and PB Resolute.
Working knowledge of Epic Slicer Dicer

Responsibilities

Works with various departments/service lines to ensure appropriate charge capture and charge reconciliation is completed daily.
Monitors Epic Revenue Integrity Dashboard(s), Epic Charge Router Work Queues and Epic Charge Review Work Queues and works with department/service line staff/management to ensure timely posting of revenue.
Review patient records and assist with account corrections, charge reconciliation based on clinical documentation.
Understand and document the Epic charge capture and reconciliation procedures for each department/service line in compliance with the organization’s Charge Capture Reconciliation Policy.
Works with departments/service lines to manage open encounters and processes corrections as necessary and communicates findings with appropriate departments/service lines.
Expected to identify, quantify impact, and participate in the resolution of any potential or actual revenue/charge related issues.
Serve as primary contact and subject matter expert on charge related workflows.
Works closely with the Charge Master Committee to ensure hospital and physician charge capture mechanisms are set up appropriately.
Advise Service Line Leaders and their staff on proper usage of charge codes.
Identify opportunities for capturing additional revenue in accordance with payer guidelines.
Review all charging related information system change requests for accuracy and appropriateness; approve additions, deletions and modifications to charges while maintaining open communication with relevant stakeholders regarding requested changes.
Develop and deploy standardized reporting, dashboards and charge reconciliation tools for departments/service lines that are meaningful to the end user.
Provide ongoing education/feedback to each department/service line and charge capture new hires.
Independently performs audit projects at all levels of complexity.
Performs other duties as assigned