Charge Master Analyst - Revenue Integrity - FT Days

University of California, Irvine•Irvine, CA

9d•Onsite

About The Position

The incumbent is responsible for the management of the Charge Description Master for all inpatient and outpatient technical charges including Room & Board Care, Pharmacy, Durable Medical Equipment, SOS 22 ambulatory care practices and ancillary services. Additional functions include charge capture development, rate analysis and appropriate alignment of hospital charges to physician charges. Incumbent is the primary liaison in providing expertise for all institutional charge application and regulatory charge guidelines for the hospital. Works independently and collaboratively, as needed, with Clinical Care Partners, Revenue Cycle Associates and IT Business Analysts to make decision regarding the Chargemaster.

Requirements

Skill to effectively work with all levels of health system personnel including directors and physicians.
Skill in ad hoc technical report writing, complex analyses and data conversion into different formats.
Skill converting master files into reports for departmental use.
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties.
Must have a clear understanding of third-party regulatory requirements including Medicare, Medicaid, Managed Care and Commercial.
Must demonstrate customer service skills appropriate to the job.
Knowledge of the healthcare industry with an in-depth knowledge of coding, billing and revenue management policies.
Knowledge of split claim billing.
Knowledge of healthcare revenue cycle function spanning across different areas as well as cost accounting and of payer reimbursement as it relates to charges.
Knowledge of coding software tools to maintain current charging and billing guidelines.
Excellent written and verbal communication skills in English.
Demonstrated advanced computer knowledge and experience with Microsoft Office.
Ability to maintain a work pace appropriate to the workload.
Ability to establish and maintain effective working relationships across the Health System.
Ability to analyze situations, define problems, research and formulate conclusions and make sound recommendations.
3 years experience with CDM management.
3 years experience in an academic or large healthcare system.
3 years experience as a Certified Professional Coder (CPC).
3 years chargemaster management experience.

Nice To Haves

Skill to read and correctly interpret governmental and commercial payor regulations and develop and implement recommendations consistent with interpretations.
Knowledge of University and medical center organizations, policies, procedures and forms.
Epic PB Resolute certification.

Responsibilities

Management of the Charge Description Master for all inpatient and outpatient technical charges including Room & Board Care, Pharmacy, Durable Medical Equipment, SOS 22 ambulatory care practices and ancillary services.
Charge capture development.
Rate analysis and appropriate alignment of hospital charges to physician charges.
Serving as the primary liaison for expertise on institutional charge application and regulatory charge guidelines.
Collaborating with Clinical Care Partners, Revenue Cycle Associates and IT Business Analysts on Chargemaster decisions.