Chargemaster Analyst

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

Primary Purpose

Team Lead responsible for Charge Description Master (CDM) Set-up and charge generation process. Responsible for preparing and reporting data required to obtain appropriate reimbursement from payers. Responsible for CDM compliance with governmental payer requirements through preparation of financial reports and process monitoring to reflect facility and department activities. Responsible for working with EPIC IT Teams to improve the accuracy of charge build. Responsible for analyzing, compiling, documenting and reporting on data and exports. Responsible for informing and providing insights to Management using available data resources.

Minimum Specifications

Education

- Bachelor's degree in Business Administration/Nursing/Accounting/ Healthcare or related field required.

Experience

- Four (4) years of health care, finance, or third-party reimbursement experience. - Three (3) years of charge description master (CDM) experience. - Prior EPIC experience in Revenue Cycle preferred.

Equivalent Education and/or Experience

- May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

Required Tests for Placement

- Must be able to successfully pass the Intermediate-Advanced level Microsoft Excel test, as established by Workforce Planning & Recruitment, with a minimum score of 70%.

Skills or Special Abilities

- Interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff. - Possess effective oral and written skills, including advanced formal presentation skills.

- Possess effective time management to permit handling of large workload and organizational and project management skills.

- Advanced knowledge of hospital operations and familiar with patient financial accounting systems.

- Ability to review, analyze and interpret managed care contracts, billing guidelines, state and federal regulations.

- Possess an advanced understanding of multiple reimbursement systems, (e.g., IPPS, OPPS, and Fee Schedules).

- Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel, Word, and Access.

- Possess advanced knowledge of accurate sources for updating all applicable code sets (e.g., CPT/HCPCS, revenue codes, ICD-10, etc.) inclusive of associated edits such as National correct coding initiative (NCCI) to monitor proper usage and establish correct billing documentation procedures

- Understanding of Coding and Medical terminology is required

Responsibilities

1. Leads and serves as a subject matter expert and in a consultative role to various levels of customers including patient accounting systems; works closely and collaboratively with other internal departments.

2. Reviews CDM change requests for accuracy and appropriateness; approves additions, deletions, and modifications to charges; imparts knowledge to facilities regarding requested changes

3. Leads special projects and special studies to facilitate revenue management as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, etc.

4. Develops, implements, and maintains Revenue Integrity-CDM policies, procedures and training materials related to Revenue Reconciliation

5. Work with Revenue Generating Departments on Revenue Reconciliation to ensure accurate and timely submission of charges for all services provided.

6. Performs and provides quality Review Audits of the Charge Capture workflow with revenue generating cost centers.

7. Reduces risk to Parkland by identifying, documenting, and reporting potential compliance issues within their specific area of accountability, such as analysis of timely contractual and liabilities or chargemaster coding reviews.

8. Identify opportunities and make recommendations for interdisciplinary and department process improvement such as analyzing Return to Providers (RTPs) or work queues. Lead department teams to implement changes, creating work plan and department procedures required.

9. Maintains positive working relationships with other hospital departments such as Patient Financial Services, Medical Records, Compliance, and the Medical Staff Office to ensure that the responsibilities of the department are performed in an expeditious and thorough manner.

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Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.