Chargemaster Specialist

Job Requisition: REQ3244

Employment type: Full time

Shift: Days

Hours per week: 40 hours

Hiring Range : $79,476.80- $109,470.40

The actual compensation for this position will be determined based on experience and other factors permitted by law.
Responsibilities:

• Maintains the chargemaster by incorporating new charges/services identified by departments, third-party changes, special requirements and coding updates.

• Conducts annual reviews of the chargemaster to identify codes that have been deleted, added or replaced and ensures required updates to code descriptions.

• Ensures organizational compliance to federal, state and local regulations as well as governmental and commercial payer guidelines as related to charge codes and chargemaster.

• Identifies services that are not being coded but are technically reimbursable and discusses these services and codes with the reporting manager to determine suitable action.

• Holds meetings to educate department managers, physicians and other staff on changes to existing charge codes, validation of inactive codes and the development of new codes.

• Audits chargemaster changes, maintains a detailed trail of these changes and communicates any change to all applicable departments.

• Participates in third-party charge audits with other dedicated teams and assists in inquiries related to chargemaster.

• Investigates CPT codes, revenue codes and other issues and resolves disputes within a stipulated time frame.

• Supports clinical units in charge capture, coding accuracy and revenue management.

• Monitors organizational uniformity in the application of charge codes for similar products and procedures.

• Prepares and provides management reports as requested.

• Performs related duties such as cost accounting, cost management, volume analysis functions and special projects as necessary.

Education, Training & Experience:

• Bachelor’s degree in business administration, accounting, management, healthcare administration or related field required.
• Minimum of Five (5) years of experience in health information management and billing required.
• Minimum of three (3) years of experience in chargemaster maintenance preferred.

Required Skills/abilities :

• Demonstrated knowledge of coding systems, including ICD, CPT and HCPCS codes.

• Knowledge of industry pricing standards and third-party reimbursement policies.

• Strong understanding of healthcare billing, charge development and reimbursement processes, as well as hospital cost accounting, management, and reporting practices.

• Ability to stay apprised of healthcare regulatory and compliance requirements, particularly regarding Medicare.

• Adept in financial analysis and data representation.

Certifications / Licensure:

• Preferred certifications. HFMA, NAHRI, AHIMA and/or AAPC

Required Skills and Attributes:

• Ability to organize and establish day-to-day priorities while using critical thinking skills in all aspects of the job.
• Must be able to multitask while remaining professional, focused, composed and positive.
• Excellent customer service skills
• Displays integrity, friendliness, and compassion.
• Must be able to establish an appropriate and effective rapport with others.
• Demonstrates flexibility
• Takes initiative
• Able to work in a fast-paced environment
• Embraces new opportunities to grow both personally and professionally.
• Effective critical thinking and problem-solving skills.
• Proficient with various Microsoft Office products (Word and Excel).
• Strong organizational skills.
• Effective interpersonal skills.
• Ability to take and follow direction in a positive and appropriate manner.
• Ability to work as part of a team and independently. Must be able to demonstrate effective and appropriate written and oral communication skills.
• Must be able to speak, read, write and follow instructions in English.