Charge Master Manager - Pa Billing
Company: Springfield Clinic
Location: Peoria
Posted on: January 24, 2023
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Job Description:
The Chargemaster Manager is responsible for assessment of
individual and departmental compliance issues and reporting any
non-compliance through the Service Line structure. Works closely
with other Revenue Cycle Departments and Service Line departments
to provide accurate, critical information needing immediate
attention to expedite compliance and recommend revenue cycle
improvements. This person will read, interpret, and distribute
payer coding and reimbursement information to all departments
affected to ensure regulatory compliance, as well as recommends and
implements pricing changes to optimize CPT / DX codes and all other
payer reimbursement.Job RelationshipsReports to Director of Revenue
IntegrityPrincipal ResponsibilitiesAssessment of individual and
departmental compliance issues and reporting any non-compliance
through the revenue cycle organizational structure.Works closely
with other Revenue Cycle Departments and Service Line departments
to provide accurate, critical information needing immediate
attention to expedite compliance and recommend revenue cycle
improvements.This person will read, interpret, and distribute payer
coding and reimbursement information to all departments affected to
ensure regulatory compliance, as well as recommends and implements
pricing changes to optimize CPT / DX codes and all other payer
reimbursement.Manage assigned staff related to the implementation
of charge master, transaction codes, and price updates as
appropriateMonitor changes requested to charges, transaction codes,
charge workflows and Allscripts system charging
functionality.Identify potential revenue, claims, and compliance
issues related to prices and charges.Work collaboratively with
Finance, Reimbursement, Operations, Revenue Cycle, Information
Systems & Technology, Compliance,and other stakeholders to identify
charge master requirements and updates required based on changes to
regulatory, coding, and contractual requirements.Develop and
maintain written procedures related to establishing, maintaining,
and monitoring charge processes.Establish controls and perform
periodic monitoring and validation of procedures and workflows to
ensure compliance with policies and procedures developed.Develop,
maintain, and distribute meaningful management reports and action
plan necessitated by performance noted in reports.Assist as
necessary with audits and investigations conducted by Legal and
Internal Audit departments.Initiate, support, and participate in
continuous quality improvement initiatives.Perform data quality
reviews on individual department chargemasters to validate CPT and
HCPCS Level II code and modifier assignments, All CPT grouping
appropriateness, missed procedures and ensures compliance with all
Telemedicine mandates and outpatient reporting
requirements.Coordinate the annual updating of CPT codes.Monitor
compliance with department, and administrative directives.Keep
abreast of new technology in chargemaster analysis and other future
issues impacting the chargemaster function.Provide and/or arrange
training of coding within the chargemaster to ensure
compliance.Ensure compliance with all Federal, State, and local
regulations.Responsible for reports, studies, analyses, or projects
as requested by the VP of RC/CFO.Responsible for all aspects of
managing and leading a team including interviewing, hiring,
training, developing, directing work and processes, managing
performance, recognizing, and rewarding
employees.Education/ExperienceBachelor--------s Degree in Business,
Accounting, Finance or Health Administration preferred.Coding
certification required.Three to Five years management experience in
healthcare accounting, finance or revenue cycle.Working knowledge
of healthcare revenue cycle functions, including coding and billing
guidelines, government payer regulations. Must have revenue code
and CPT coding knowledge.Demonstrated knowledge of hospital
pricing/charging and claims/reimbursement requirements and
processes. Rural Health care billing experience a plus.Demonstrated
success managing, monitoring, and optimizing information systems
related to pricing, charging, and charge master systems and
applications.Ability to interpret and implement regulatory
standards.Licenses/CertificationsBachelor--------s Degree in
Business, Accounting, Finance or Health Administration
preferred.Coding certification required.Three to Five years
management experience in healthcare accounting, finance or revenue
cycle.Knowledge, Skills and AbilitiesExcellent interpersonal and
communication skills to positively interact with a variety of
personnel, including administrative and management staff.Highly
skilled experience and knowledge of Windows-based software
required, including but not limited to Microsoft Windows, Excel,
and Access. In addition, working knowledge of Allscripts/TW/Curves
reports, Experian, RCXProficient skills to collect, organize and
analyze data, produce meaningful reports, and recommend
improvements and solutions.Working EnvironmentOnsitePHI/Privacy
LevelHIPAA 4
Keywords: Springfield Clinic, Peoria , Charge Master Manager - Pa Billing, Accounting, Auditing , Peoria, Illinois
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