Charge Master Specialist (CDM) (Chargemaster - Revenue Integrity Analyst)

Augusta Health • Fishersville, VA

5d

About The Position

This position plays a critical role in supporting Augusta Health’s mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities. The Charge Master Specialist is responsible for the formulation and maintenance of all charge masters for the organization. Responsibilities include but are not limited to coordinating and reviewing all changes for the Charge Master, ensuring all charge changes are reviewed by appropriate staff, are compliant with all third-party payer regulations and requirements, and inform administrative and management staff of requirements. Works as a team member with Business Office personnel and other groups as assigned. Ability to work through a matrix organization and effectively work with all levels of organization personnel, physicians, third party payers, public and others.

Requirements

• High School Diploma
• Minimum of 1 year of revenue cycle experience in the areas of charge capture, payer reimbursement, billing and or coding.
• Eligibility to work in the United States and meet Virginia state employment requirements

Nice To Haves

• Associates or Bachelor’s Degree in relevant discipline.
• Holds a certification through AAHAM, AAPC, HFMA or other nationally recognized revenue cycle association
• 3-5 years of direct Charge Master maintenance experience in a hospital setting.
• Experience conducting CDM audits, charge capture reviews, or working with external CDM review vendors.
• Experience with Meditech Expanse.
• Experience developing charge capture workflows, policies or training materials.
• Prior experience in a hospital, healthcare system, or related service-oriented environment.
• Familiarity with Augusta Health’s systems, workflows, or organizational culture is a plus.
• Working knowledge of healthcare billing, medical terminology, and skill in the use of computer software and keyboard applications.
• Must be able to work independently, relate to various groups of professionals, especially physicians, and maintain confidentiality of patient information and other correspondence.
• Must be objective, tactful, assertive, and discreet.
• Must maintain excellent personal dress and hygiene.
• Strong oral and written communication skills are required.
• Positive Attitude.
• Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions.

Responsibilities

• Coordinates, monitors and approves all changes made to the Charge Master within the organization’s guidelines.
• Reviews all third-party payer charging requirements related to claims filing, coding, and adjudication on a periodic basis.
• Responsible for ensuring all charge changes are processed in accordance with the established policy, compliant with all third-party payer regulations and requirements, and in an efficient manner.
• Monitors/reviews all third-party payer laws, rules, regulations and requirements related to charging.
• Communicates this information to appropriate staff, coordinates any necessary changes and monitors for compliance after implementation.
• Coordinates periodic comprehensive charge master reviews.
• Provides educational charge master information to organization staff, physicians and others as requested.
• Safeguards and preserves confidentiality of patient information in accordance with hospital policy.
• Maintains current knowledge of compliance regulations related to charging.
• Completes responsibilities in a timely manner.
• Organizes and prioritizes workload so that deadlines are met.
• Demonstrates a consistent level of performance.
• Attempts to avoid periods of extreme high and low activity levels.
• Maintains progress on special assignments.
• Acquire knowledge of software systems utilized by Business Office.
• Proficient in use of report generating functions for Meditech applicable modules and other software utilized by the BO.
• Maintain skills and knowledge of current Microsoft Office software version.
• Acquire knowledge and maintain proficiency in gathering data from all software products utilized for compilation.
• Develop and maintain reports, statistics and special data requirements from a variety of software products into a single format efficiently and accurately.
• Perform research as assigned.
• Develop knowledge and proficiency of researching resources such as thru the Internet, manuals, and others.
• Demonstrates knowledge of all computer software utilized by Augusta Health and sources of information.
• Ability to research, compile and summarize data/information for projects efficiently.
• Demonstrates ability to abstract pertinent patient information from patient registration, billing, and medical records.
• Demonstrates ability to use Meditech and other software with skill.
• Keeps up to date with MIS changes; seeks MIS or other software support as needed.
• Possesses an awareness of hospital systems and procedures, location of all departments, treatment areas, and other patient services.
• Attempts to remain current with hospital changes by reading interdepartmental memos, hospital newsletters, bulletin boards, etc.
• Demonstrates active interest in improving current level of skills and knowledge by independently participating in CE activities and professional associations.
• Strives to attend 1 to 2 seminars or conferences yearly (as available).
• Recognizes role as Business Office Charge Master Specialist in department and how it relates to overall function of hospital.
• Follows appropriate channels of communication and chain of command.
• Strives to be a productive and contributing member of the department and organization.
• Demonstrates initiative and self-direction with departmental tasks and responsibilities; assists in development of policies and procedures applicable to department.
• Assists in identifying problem situations or opportunities to improve charging process.
• Shows ability to analyze situations from a variety of perspectives, considers alternatives, and offers recommendations for resolution.
• Advise appropriate personnel of situations requiring follow-up attention.
• Demonstrates ability to communicate information and express ideas clearly.
• Seeks guidance and direction as necessary for successful completion of job duties.
• Consults with supervisor and other professional staff on issues or dilemmas affecting job duties.
• Demonstrates understanding of department budget constraints.
• Strives to conserve department supplies; looks for more efficient use of department resources.
• Demonstrates ability to relate well to all levels of staff; enjoys working and interacting with people.
• Can work effectively with others, regardless of position or background.
• Maintain professional relations with staff members.
• Demonstrates a service orientation; responds to requests/inquiries in a courteous and cooperative manner.
• Interacts with co-workers in a pleasant, respectful and cooperative manner.
• Works as a team member; will offer to assist others when needed; respects rights, privacy, and property of co-workers.
• Demonstrate effective social and communication skills.
• Conveys instruction, directions, and information clearly and appropriately.
• Actively participates on inter and intradepartmental committee and special task forces as assigned.
• Represents department in a professional manner, communicates effectively; conveys directions and information clearly and appropriately.
• Will perform other duties as assigned by supervisor.
• Accepts additional responsibility in a cooperative and professional manner.
• Ability to handle occasional intense demands as may arise from meeting deadlines and/or from dealing with confidential and/or volatile situations.

Benefits

• Comprehensive insurance package including medical, dental, and vision coverage.
• Retirement savings plans and financial wellness support programs.
• Generous paid time off and flexible scheduling to promote work-life balance.
• Career development programs including clinical ladders, shared governance, and advancement opportunities.
• Personalized onboarding with dedicated preceptors and ongoing educational support.
• Tuition reimbursement and access to onsite childcare.
• Free onsite parking, 24/7-armed security for your safety, a Health Fitness Reimbursement Program, and an onsite credit union and pharmacy.
• Competitive pay with shift/weekend differentials.
• Employee discounts at the cafeteria, gift shop, pharmacy, and local entertainment venues (i.e., movie tickets).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED