Senior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)

NorthBay Health•Fairfield, CA

4d•$47 - $57

About The Position

The Senior Systems Specialist, Chargemaster ensures the accuracy and compliance of NorthBay Health’s Chargemaster across the organization. Serving as an expert and liaison among Finance, clinical departments, and hospital-based clinics, the role supports compliance by overseeing system data revisions, participating in high-priority Chargemaster projects and meetings, and helping develop and deliver staff training. The position contributes to revenue-cycle optimization and regulatory compliance. The role manages the long-term integrity and updates of the Chargemaster, including CPT and HCPCS pricing, and supports configuration across relevant software applications. It works with hospital departments and Information Technology to plan and maintain an optimized Chargemaster across integrated systems; develops and implements supporting policies, procedures, tools, and forms; and assists departments with compliance audits and quality assurance. The specialist reviews error reports, audit findings, regulatory updates, billing manuals, and reimbursement issues, and coordinates implementation of necessary corrections and changes to APCs, DRGs, and payer fee schedules. The specialist also supports Chargemaster software and charge-service interfaces, trains users on batch charge entry, performs regular department audits to improve charge-capture accuracy, and provides updates to the Revenue Integrity Manager. The role requires effective collaboration, communication, meeting facilitation, project management, and management of multiple priorities. The position may be performed onsite or remotely, with onsite work preferred according to business needs. Remote candidates must be in the continental United States; remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, or the U.S. Virgin Islands. The role requires eight hours of work per day and consistent attendance during agreed-upon hours.

Requirements

Bachelor’s degree in Computer Systems, Business, or Nursing, or eight years of Revenue Cycle Management experience.
At least five years of hospital business office experience, or three years of clinical patient care experience and two years of medical business office experience.
Experience with interfaces.
Strong organizational and meeting facilitation skills.
Strong project management capabilities.
Ability to read and interpret regulatory information related to billing of Chargemaster data.
Proficiency in Microsoft Office applications, especially Excel, PowerPoint, Word, and Access.
Knowledge of internet and government websites.
Ability to communicate clearly and effectively through listening, speaking, and writing.
PC literacy, including accessing network resources, shared files, forms, and online reports and performing related tasks.
Ability to copy and paste information between host systems and documents.
Ability to interact professionally and courteously with coworkers, employers, patients, providers, and others.
Knowledge of CPT, HCPCS, Revenue Codes, and data flow within the Chargemaster and related files.
Knowledge of claims processing and remittance data.
Knowledge of Medicare regulations.
Knowledge of APCs and other payment methodologies that drive Chargemaster updates.
Ability to work effectively with people of varied backgrounds, education, and skills in a team environment and manage multiple priorities.
Demonstrate NorthBay Health’s True North values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence.
Adhere to established policies and procedures and meet attendance and punctuality expectations.

Nice To Haves

Two years of hospital Medicare billing experience is strongly preferred.

Responsibilities

Manage the long-term integrity of the Chargemaster, including pricing for CPT and HCPCS codes.
Manage updates and modifications to the Chargemaster.
Assist with Chargemaster configurations across relevant software applications.
Collaborate with hospital departments and Information Technology to develop a strategic roadmap for an optimized and compliant Chargemaster across integrated systems.
Develop and implement policies, procedures, tools, and forms that support efficient Chargemaster maintenance.
Assist departments with Chargemaster compliance, audits, and quality assurance activities.
Participate in cross-functional meetings with Patient Financial Services, Information Systems, Health Information Management, and clinical departments to analyze error reports, audit findings, and regulatory updates.
Follow up on outstanding issues and tasks, and facilitate meetings to implement necessary corrections.
Escalate issues to the Manager, Revenue Integrity, as appropriate.
Assist with ongoing billing compliance by reviewing billing manuals and regulatory requirements with staff and departments.
Lead preparation, education, implementation, and ongoing monitoring of changes to APCs, DRGs, and payer fee schedules.
Research complex reimbursement issues and collaborate with department directors on adaptation and compliance.
Assist with Chargemaster compliance initiatives, including investigations and findings related to Chargemaster billing data.
Assist with maintenance of Chargemaster software applications.
Collaborate with Information Technology and relevant departments to improve charge-service activity interface efficiency and functionality.
Train users on batch charge entry procedures.
Provide regular updates to the Revenue Integrity Manager.
Pursue professional growth through educational programs, seminars, and other learning opportunities.
Perform regular department audits to maximize and ensure charge-capture accuracy.

Benefits

Medical insurance
Dental insurance
Vision insurance
Life insurance
Disability coverage
Long-term care coverage
Paid time off, including vacation, sick leave, holidays, and bereavement
403(b) retirement plan with employer match
Education reimbursement for eligible roles
Professional development and training programs
Employee Assistance Program
Wellness programs
Recognition programs
Shift differentials
Market-based compensation review and increases, subject to approval and organizational performance