Senior Systems Analyst, Chargemaster

NorthBay Health•Fairfield, CA

About The Position

At NorthBay Healthcare the Senior Systems Analyst, Chargemaster is responsible for ensuring a compliant Charge Master (CDM) data file and for the maintenance of the files within all affected software applications. Responsible for maintaining Chargemaster compliance in accordance with regulatory guidelines. The Senior Analyst serves as a liaison between Finance and all clinical hospital departments including hospital based clinic departments, providing expert guidance on all Chargemaster related issues. Acts as an application and subject matter expert and resource for System Managers in the area of Chargemaster related issues. Serves as a leader in Charge Master meetings and related projects. Conducts and/or oversees data entry of Charge Master revisions. Directs Chargemaster training sessions for System staff as needed. This role involves actively participating in and leading Chargemaster meeting, projects, overseeing data revisions, and directing training sessions for system staff to maintain regulatory compliance and optimize revenue integrity. At NorthBay Health, we are guided by our values: Nurturing Care; Own It; Respect; Build Trust; and Hardwire Excellence. These principles lead us to our TRUE NORTH and inspire us to provide exceptional care. These values serve as the foundation of everything we do, guiding us to deliver individualized care with integrity and accountability. We are committed to fostering a culture of collaboration, where every team member is valued and empowered to contribute their best to the health and well-being of those we serve. This is an exciting time to join NorthBay Health. As an independent, nonprofit health system north of the San Francisco Bay Area, in the Napa/Solano Region, we are expanding our footprint across Solano, Yolo, and Napa counties to meet the evolving needs of our communities. With two acute-care hospitals—including a Level II Trauma Center and a modern maternity unit with a Level III Neonatal Intensive Care Unit (NICU)—along with a comprehensive cancer center, multiple urgent care facilities, and a growing network of primary and specialty clinics, we are investing in the future of care across the region. NorthBay Health we are home to advanced clinical programs and nationally recognized cardiovascular, neuroscience, and orthopedic services, as well as comprehensive surgical and outpatient specialties. Our commitment to excellence is reflected in our Magnet with Distinction designation for nursing (one of only 12 organizations nationwide) and recognition from U.S. News & World Report as “High Performing” in multiple clinical areas, including maternity care, heart failure, and stroke. NorthBay Medical Center has earned the High Performing designation in maternity care for four consecutive years. As the only locally governed health system in the region, we remain deeply rooted in our communities while growing into a trusted regional healthcare leader. If you are seeking meaningful work, collaborative teams, and the opportunity to help shape the future of healthcare in Northern California, you will find it at NorthBay Health. Join us with our commitment to excellence, to achieve our vision to be the trusted healthcare partner of choice for the communities we serve. To learn more about NorthBay Health's benefits, diversity statement and community please visit https://www.northbay.org/careers/ [https://www.northbay.org/careers/index.cfm]

Responsibilities

Manages the chargemaster’s long term integrity, including pricing for CPT and HCPC codes. Manages all updates and modifications to the CDM
Serves as the lead subject matter expert for Chargemaster pricing during annual reviews.
Manages chargemaster configurations across all relevant software applications
Drives cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant chargemaster across all integrated systems.
Drives the timely implementation for all annual CPT, HCPCS, and modifier updates ensuring organizational readiness and regulatory compliance for chargemaster data.
Develops and implements comprehensive policies, procedures, tools and forms to support efficient chargemaster maintenance.
Accountable for the integrity of the chargemaster compliance, including all auditing and quality assurance activities.
Facilitates cross-functional meetings with key stakeholders including patient financial services, information systems, health information management and clinical departments to proactively analyze error reports, audit findings and regulatory updates. EN sures the ongoing accuracy and compliance of the chargemaster.
Follow up on outstanding issues and tasks, facilitating meeting with relevant hospital department and administrative representatives to implement necessary corrections. Escalates issues to the Manager, Revenue Integrity as appropriate.
Ensures ongoing billing compliance by reviewing billing manuals and regulatory requirements with staff and relevant hospital departments and by providing continuous education to adhere to all contractual and regulatory stipulations.
Leads preparation, education, implementation and ongoing monitoring of changes to APC’s, DRG’s and all payer fee schedules. This includes researching complex reimbursing issues and collaborating directly with department directors to ensure seamless adaptation and compliance.
Oversees chargemaster compliance initiatives, collaborating closely with the compliance office to monitor investigatory activities and findings that relate to billing chargemaster data.
Manages and submits all the required HCAI CDM information, ensuring timely file submission in accordance with regulatory timelines.
Develops new CDM item and service pricing strategies informed by market and competitor research.
Provides monthly CDM updates to the organization. Manages the maintenance of CDM software applications.
Manages the annual pricing strategy project, overseeing all activities from planning to the implementation of revisions.
Collaborates with IT and relevant department to optimize the efficiency and functionality of charge services activities interfaces.
Develop and delivers training on batch charge entry procedure to relevant users.
Provides regular updates to Manager, Revenue Integrity.
Enhances professional growth and development through educational programs, seminars, etc.
Preform regular department audits to maximize and ensure the accuracy if charge capture