Charge Master Specialist, Observation Charge Audit

Sutter Health•Sacramento, CA

2d•$117,437 - $176,155

About The Position

Serves as a charge capture and charge description master (CDM) expert to clinical service line leaders for complex procedure areas such as Interventional Radiology, the Operating Room, or Observation across Sutter Health. Focuses on specific clinical service lines to ensure best practices and champions standardization of the charge capture process while ensuring discipline-specific charge capture meets government and commercial payer requirements. Performs charge reconciliation, researches industry best practices, and identifies and deploys charge capture improvement initiatives. Identifies charge capture revenue management opportunities and reviews and monitors service-line-specific reimbursement and revenue management. The role typically requires five years of recent relevant experience and a bachelor’s degree in Health Information or a science field such as Nursing, Imaging, or Clinical Laboratory; equivalent experience may be accepted instead of the degree. Depending on the service line supported, a California RN, RHIT, RHIA, CPC, or COC credential may be required, or no certification may be required.

Requirements

Bachelor’s degree in Health Information or a science field such as Nursing, Imaging, or Clinical Laboratory, or equivalent experience in lieu of the degree.
Five years of recent relevant experience.
Depending on the supported service line, one of the following may be required: California Registered Nurse (RN), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or no certification.
In-depth knowledge of medical and billing terminology, common procedure terminology, HCPCS, and revenue codes.
Knowledge of government and/or commercial payer requirements and Federal, State, and Local regulatory publications and how to access them.
Knowledge of CDM and charge capture management functions in acute and non-acute settings and how they interrelate.
Knowledge of healthcare billing and collections principles, methods, and techniques.
Ability to execute strategy and communicate business processes and enabling technologies in a CDM/charge capture function.
Well-developed process design, implementation, and improvement skills.
Accuracy, attentiveness to detail, and time-management skills.
Ability to conceptualize, plan, and implement goals and objectives.
Ability to manage multiple tasks and projects in a fast-paced environment with productivity requirements and diverse work styles.
Strong problem identification, mitigation, and resolution, analytical, and financial skills.
Ability to develop effective working relationships and networks within and outside the organization.
Ability to communicate verbally and in writing through one-on-one contact, formal presentations, and group discussions.
Ability to use spreadsheet, word processing, statistical, project management, and presentation software; Microsoft Suite and EPIC patient management information system knowledge are preferred.

Nice To Haves

Knowledge of Microsoft Suite.
Knowledge of EPIC patient management information system applications.

Responsibilities

Serve as the charge capture and charge description master expert for clinical service line leaders in complex procedure areas.
Promote best practices and standardize charge capture processes across supported clinical service lines.
Ensure discipline-specific charge capture complies with government and commercial payer requirements.
Perform charge reconciliation activities.
Research industry best practices and identify and implement charge capture improvement initiatives.
Identify charge capture revenue management opportunities.
Review and monitor service-line-specific reimbursement and revenue management.
Develop and deliver service-line education materials.