Charge Master Manager

1 week ago

Garden City, New York, United States St. John's Episcopal Hospital Full time
Job Title: Charge Master Manager

St. John's Episcopal Hospital is seeking a highly skilled Charge Master Manager to join our Revenue Cycle team. As a key member of our team, you will be responsible for the formulation and maintenance of the Charge Description Master to optimize revenue generation and maintain compliance with third-party requirements and Price Transparency regulations.

Key Responsibilities:

  • Evaluate the impact of innovations and changes in programs, policies, and procedures relative to the capture of charges for services rendered and related coding, classification, and pricing.
  • Design and implement systems and methods to improve charge integrity and charge capture compliance.
  • Identify, assess, and resolve issues impacting the charge capture, documentation, and related revenue cycle processes while providing guidance to charge capture workflows.
  • Keep the Charge Description Master (CDM) current and accurate with regard to changes requested by clinical and ancillary departments and pricing updates.
  • Make timely updates to the CDM when new regulations are published and coordinate their implementation with changes to the responsible department managers.
  • Assist and guide resolution of NCCI, OCE, and MUE Billing Edits; requiring in-depth knowledge of revenue codes, CPT/HCPCS Level II codes, billing and coding edits, and billing reimbursement practices.
  • Manage upgrades, user troubleshooting, and perform administrative responsibilities for the facility setup and maintenance for CDM/charging/pricing software programs.
  • Educate departments and providers with respect to the use and maintenance of the charge master and charging philosophy.
  • Oversee, coordinate, and maintain Price Transparency requirements for the health system.
  • Oversee, coordinate, and maintain the Financial Assistance Program policies and procedures.
  • Audit system reports to address charging issues.
  • Develop and maintain documentation on charge master data management, pricing, and price transparency processes and procedures.

Requirements:

  • Associate's Degree in Healthcare Administration, Business Administration, or related field required; Bachelor's Degree preferred.
  • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.
  • Experience with coding systems such as ICD-10-CM/PCS, CPT-4, HCPCS Level II, and/or Medical Billing Codes.
  • Experience with billing and claims management systems in a hospital setting, Meditech preferred.
  • Knowledge of Medical Terminology, Anatomy, and Physiology.
  • 2-3 years experience in a healthcare or medical billing setting, charge master data experience preferred.
  • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and Google Suite (Google Sheets, Google Docs).
  • Familiarity with healthcare industry regulations governing privacy, billing and reimbursement, pricing, and price transparency.
  • Excellent analytical, organizational, and communication skills.

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