Charge Master Services Expert - Finance - Full Time
About The Position
This role is a key driver of financial health, responsible for minimizing revenue leakage and ensuring 24/7 regulatory compliance. You will utilize advanced analytics to oversee the resolution of billing bottlenecks (DNFB, CEWL, EBEW) and ensure that the PBO platform remains a high-performing, compliant engine for all facility and professional charges. Key Performance Indicators (KPIs) include: Clean Claim Velocity: Maintain a 48-hour release target by eliminating PBO charge router edits and CDM-related pre-bill holds. DNFB & CEWL Reduction: Maintain unbilled account volumes within top-quartile industry benchmarks through aggressive root cause resolution. Charge Integrity Rate: Achieve >99% accuracy in annual audits of the PBO-to-Clinical system mapping. Audit Defensibility: Maintain a 100% compliance rate with government and commercial audit deadlines.
Requirements
- Bachelor’s degree in healthcare
- AAPC Coding Certification (Professional & Technical) required for hire or must be obtained within 1 year of employment
- Proven mastery of the PBO (Patient Business Office) platform workflows, including the interrelation between clinical triggers, charge routers, and final claim generation
- Expert-level understanding of Behavioral Health, ASC-covered procedures, and acute care reimbursement models
- 5 years in CDM maintenance and Medicare billing
- Expert proficiency in CDM tools (e.g., Panacea)
Responsibilities
- Minimize revenue leakage
- Ensure 24/7 regulatory compliance
- Utilize advanced analytics to oversee the resolution of billing bottlenecks (DNFB, CEWL, EBEW)
- Ensure the PBO platform remains a high-performing, compliant engine for all facility and professional charges
- Maintain a 48-hour release target by eliminating PBO charge router edits and CDM-related pre-bill holds
- Maintain unbilled account volumes within top-quartile industry benchmarks through aggressive root cause resolution
- Achieve >99% accuracy in annual audits of the PBO-to-Clinical system mapping
- Maintain a 100% compliance rate with government and commercial audit deadlines
Benefits
- Generous Paid Time Off (PTO)
- Medical, Prescription Drug, Dental & Vision Insurance
- Retirement Plans with employer contributions
- Short-Term & Long-Term Disability Coverage
- Life & Accidental Death & Dismemberment Insurance
- Tuition Reimbursement
- Flexible Spending Accounts (FSAs) for healthcare and dependent care
- Wellness Programs
- Voluntary Benefits, including Pet Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
