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

NorthBay Healthcare Corporation•Fairfield, CA

About The Position

At Northbay Health, the Senior Systems Specialist, Chargemaster, helps ensure an accurate and compliant Chargemaster across the organization. The role serves as an expert and liaison between Finance, clinical departments, and hospital-based clinics on Chargemaster matters. It supports compliance by overseeing system data revisions, participating in high-priority projects and meetings, and helping develop and deliver training for system staff. The position contributes to revenue-cycle optimization and regulatory compliance. The role manages Chargemaster integrity, including pricing for CPT and HCPCS codes, and handles updates, modifications, configurations, and maintenance across relevant software applications. It collaborates with hospital departments and Information Technology on a strategic roadmap for an optimized, compliant Chargemaster across integrated systems. It also develops and implements maintenance policies, procedures, tools, and forms; supports departmental compliance, auditing, and quality assurance; and participates in cross-functional review of error reports, audit findings, and regulatory updates. The Specialist follows up on outstanding issues, facilitates meetings to implement corrections, and escalates issues to the Manager, Revenue Integrity as appropriate. The role supports billing compliance by reviewing manuals and regulatory requirements, and leads preparation, education, implementation, and monitoring of changes to APCs, DRGs, and payer fee schedules. It researches complex reimbursement issues, supports compliance investigations, maintains CDM software applications, helps optimize charge-service interfaces, trains users on batch charge entry, reports regularly to the Revenue Integrity Manager, and performs department audits to improve charge-capture accuracy. The position requires eight hours of work per day and consistent attendance during agreed-upon hours. It may be performed onsite or remotely, with onsite work preferred based on business needs. Remote candidates must be located within 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 involves minimal physical effort, frequent sitting, and occasional lifting or moving of boxes and supplies, squatting, standing, walking, and driving.

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 plus 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 CDM data.
Proficiency in Microsoft Office, especially Excel, PowerPoint, Word, and Access.
Knowledge of internet and government websites.
Ability to communicate clearly and effectively through listening, speaking, and writing, including writing policies, procedures, and internal and external communications.
Ability to work effectively with people of varied backgrounds, education, and skills in a team environment.
Ability to manage multiple priorities effectively.
Ability to interact professionally and courteously with coworkers, employers, patients, providers, and others.
PC literacy, including use of bulletin boards, eligibility files, websites, shared drives, and network folders to access or edit forms and reports.
Ability to copy and paste information between host systems and documents.
Knowledge of CPT, HCPCS, Revenue Codes, Chargemaster data elements, and related data flows.
Knowledge of claims processing and remittance data.
Knowledge of Medicare regulations.
Knowledge of APCs and other payment methodologies that drive Chargemaster updates.
Consistent attendance and work during agreed-upon hours.

Nice To Haves

Two years of hospital Medicare billing experience is strongly preferred.
Ability to work onsite and live within a reasonable commuting distance is preferred.

Responsibilities

Manage the long-term integrity of the Chargemaster, including pricing for CPT and HCPCS codes.
Manage updates and modifications to the CDM.
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 for efficient Chargemaster maintenance.
Assist departments with Chargemaster compliance, including auditing and quality assurance activities.
Participate in cross-functional meetings to analyze error reports, audit findings, and regulatory updates.
Follow up on outstanding issues and tasks, facilitate meetings to implement corrections, and escalate issues to the Manager, Revenue Integrity as appropriate.
Assist with 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 to support adaptation and compliance.
Assist with Chargemaster compliance initiatives, including investigations and findings related to Chargemaster billing data.
Assist with maintenance of CDM software applications.
Collaborate with Information Technology and relevant departments to optimize charge-service interface efficiency and functionality.
Assist with training 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.