Woman's
Chargemaster Specialist - Revenue Integrity - Full-Time
Woman's, Baton Rouge, Louisiana, us, 70873
Chargemaster Specialist - Revenue Integrity - Full-Time
Job Category : ProfessionalRequisition Number : CHARG007177Posted:
September 16, 2024Location:
Woman's Hosp Main Campus100 Woman's WayBaton Rouge, LA 70817, USAThe Chargemaster Specialist shall ensure the Chargemaster (CDM) is complete, accurate, standardized and consistent with all coding and billing regulations in regard to revenue capture, revenue improvement opportunities, hospital patient charge (price) setting, accurate billing, and is also compliant with governmental and third-party requirements, contract terms, and regulations. The chargemaster specialist also acts as a liaison between Revenue Integrity and all hospital ancillary departments regarding matters of the CDM in support of the hospital’s ability to grow and further the mission to create a healthier future for women and infants.Requirements:High school diploma or equivalent.Associates degree in business or healthcare related field preferred.Epic experience preferred.Two years hospital chargemaster (CDM) or charge capture experience related to revenue cycle, billing, finance, coding, compliance, revenue integrity and/or reimbursement measures.Experience with CDM maintenance tools/software such as Craneware, Vitalware or nThrive/FinThrive preferred.Hospital electronic medical record (EMR) CDM experience in Meditech and/or EPIC environment preferred.CCS (AHIMA), CPC, CPC-H (AAPC), RHIT or RHIA certification preferred.Responsibilities:Primarily responsible for setting up, modifying, inactivating, maintaining, and supporting charge configuration in the chargemaster (CDM) using chargemaster software, EPIC CDM spreadsheet and submitting Help Desk tickets to IS for incorporation of charges into production environment.Research competitive pricing structure, CPT code, revenue code, compliance, billing and reimbursement feasibility of charge set up in alignment with compliance, billing and reimbursement requirements.Supports charge capture consistent with governmental and non-governmental regulatory requirements ensuring new services and/or products are appropriately coordinated (with respect to revenue cycle) and that all charges related to the new service and/or an expanding service are identified, reviewed, built within the CDM and an appropriate charge generation model is selected.Actively assigns pricing for hospital based (HB) and professional based (PB) charges using Woman’s organizational pricing methods calculated from state percentiles, comparative pricing, specific PB formula, supply mark-up formulas and other administrative approved methods as outlined in organizational policies and procedures.Monitors and updates all charges making sure coding and charge descriptions are compliant with industry and government standards (NCD, LCD, CCI edits), legal mandates, and reporting requirements; participates in scheduled, regular analysis of CPT codes, HCPC codes, charge descriptions, multipliers, revenue code compatibility, etc. to complete financial impact analysis and maintain a high level of CDM accuracy.Performs daily review and resolution of various charge reports, worklists, charge debits, credits and rejections, by appropriately resolving discrepancies for timely billing.Assists in resolution of third-party payor billing problems via tracking, monitoring, and reducing bill holds as Patient Financial Services identifies them. Also, follows up on billing issues created by charge capture errors.Works with Managed Care contracting department to gain an understanding of payer reimbursement methodologies and coverage requirements.Acts as a liaison to hospital revenue generating clinical departments, Finance, Patient Accounting, Clinical Directors/Hospital Revenue Generating Departments, Materials Management, Managed Care, Pharmacy, IS, Medical Staff, Nursing, Allied Health Professionals and anyone with a direct impact on revenue cycle.Responsible for working with Revenue Integrity Specialist and Materials Management (MM) team to research supply items including HCPCS and revenue applicable codes, assigns EPIC charge code ID to assist with building supply charges in Meditech. Works with MM to ensure supplies are included in correct clinical inventories. Works with IS/EPIC to ensure supplies are priced and built accurately according to current markup formulas and are ready for use from a charge perspective. Fully understands mark-up schedule and supply charging principles.Works with clinical charge champions, management, and directors to implement and monitor CDM changes by evaluating department requests to ensure all additions, changes and deletions are consistent with state and Federal regulatory guidelines, proper charging practices, and result in expected reimbursement.Serves as the primary resource, expert and educational supporter for revenue generating department charge champions and clinical administrators concerning CDM and related software, charging and revenue integrity principles.Any other duties as assigned by Woman's Hospital.Schedule:Full-Time; Monday - Friday7:30 AM – 4:00 PMPay Range:Hourly/Non-Exempt$17.00 – $24.00A Work Experience with PurposeWoman’s is one of the largest specialty hospitals for women and infants in the United States. We are recognized throughout the country for our innovative programs, and we pride ourselves in surpassing the expectations of those we serve. Providing exceptional patient care and creating exceptional patient experiences are at the center of what we do at Woman’s. Our team consistently exceeds state and national benchmarks for patient satisfaction.Our employees, organizational culture, mission, vision, values, and benefits make Woman’s a best place to work. In fact, for the
17th year in a row , Woman’s has been recognized as a Best Place to Work by Modern Healthcare – making us the only healthcare organization to earn the distinction every year since the program’s inception. We are proud of the level of care our staff provides to our patients and each other.If you have any questions or would like to connect with one of our recruiters directly, please e-mail
hrjobs@womans.org.We are an equal opportunity employer and value diversity and inclusion at Woman’s Hospital. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
#J-18808-Ljbffr
Job Category : ProfessionalRequisition Number : CHARG007177Posted:
September 16, 2024Location:
Woman's Hosp Main Campus100 Woman's WayBaton Rouge, LA 70817, USAThe Chargemaster Specialist shall ensure the Chargemaster (CDM) is complete, accurate, standardized and consistent with all coding and billing regulations in regard to revenue capture, revenue improvement opportunities, hospital patient charge (price) setting, accurate billing, and is also compliant with governmental and third-party requirements, contract terms, and regulations. The chargemaster specialist also acts as a liaison between Revenue Integrity and all hospital ancillary departments regarding matters of the CDM in support of the hospital’s ability to grow and further the mission to create a healthier future for women and infants.Requirements:High school diploma or equivalent.Associates degree in business or healthcare related field preferred.Epic experience preferred.Two years hospital chargemaster (CDM) or charge capture experience related to revenue cycle, billing, finance, coding, compliance, revenue integrity and/or reimbursement measures.Experience with CDM maintenance tools/software such as Craneware, Vitalware or nThrive/FinThrive preferred.Hospital electronic medical record (EMR) CDM experience in Meditech and/or EPIC environment preferred.CCS (AHIMA), CPC, CPC-H (AAPC), RHIT or RHIA certification preferred.Responsibilities:Primarily responsible for setting up, modifying, inactivating, maintaining, and supporting charge configuration in the chargemaster (CDM) using chargemaster software, EPIC CDM spreadsheet and submitting Help Desk tickets to IS for incorporation of charges into production environment.Research competitive pricing structure, CPT code, revenue code, compliance, billing and reimbursement feasibility of charge set up in alignment with compliance, billing and reimbursement requirements.Supports charge capture consistent with governmental and non-governmental regulatory requirements ensuring new services and/or products are appropriately coordinated (with respect to revenue cycle) and that all charges related to the new service and/or an expanding service are identified, reviewed, built within the CDM and an appropriate charge generation model is selected.Actively assigns pricing for hospital based (HB) and professional based (PB) charges using Woman’s organizational pricing methods calculated from state percentiles, comparative pricing, specific PB formula, supply mark-up formulas and other administrative approved methods as outlined in organizational policies and procedures.Monitors and updates all charges making sure coding and charge descriptions are compliant with industry and government standards (NCD, LCD, CCI edits), legal mandates, and reporting requirements; participates in scheduled, regular analysis of CPT codes, HCPC codes, charge descriptions, multipliers, revenue code compatibility, etc. to complete financial impact analysis and maintain a high level of CDM accuracy.Performs daily review and resolution of various charge reports, worklists, charge debits, credits and rejections, by appropriately resolving discrepancies for timely billing.Assists in resolution of third-party payor billing problems via tracking, monitoring, and reducing bill holds as Patient Financial Services identifies them. Also, follows up on billing issues created by charge capture errors.Works with Managed Care contracting department to gain an understanding of payer reimbursement methodologies and coverage requirements.Acts as a liaison to hospital revenue generating clinical departments, Finance, Patient Accounting, Clinical Directors/Hospital Revenue Generating Departments, Materials Management, Managed Care, Pharmacy, IS, Medical Staff, Nursing, Allied Health Professionals and anyone with a direct impact on revenue cycle.Responsible for working with Revenue Integrity Specialist and Materials Management (MM) team to research supply items including HCPCS and revenue applicable codes, assigns EPIC charge code ID to assist with building supply charges in Meditech. Works with MM to ensure supplies are included in correct clinical inventories. Works with IS/EPIC to ensure supplies are priced and built accurately according to current markup formulas and are ready for use from a charge perspective. Fully understands mark-up schedule and supply charging principles.Works with clinical charge champions, management, and directors to implement and monitor CDM changes by evaluating department requests to ensure all additions, changes and deletions are consistent with state and Federal regulatory guidelines, proper charging practices, and result in expected reimbursement.Serves as the primary resource, expert and educational supporter for revenue generating department charge champions and clinical administrators concerning CDM and related software, charging and revenue integrity principles.Any other duties as assigned by Woman's Hospital.Schedule:Full-Time; Monday - Friday7:30 AM – 4:00 PMPay Range:Hourly/Non-Exempt$17.00 – $24.00A Work Experience with PurposeWoman’s is one of the largest specialty hospitals for women and infants in the United States. We are recognized throughout the country for our innovative programs, and we pride ourselves in surpassing the expectations of those we serve. Providing exceptional patient care and creating exceptional patient experiences are at the center of what we do at Woman’s. Our team consistently exceeds state and national benchmarks for patient satisfaction.Our employees, organizational culture, mission, vision, values, and benefits make Woman’s a best place to work. In fact, for the
17th year in a row , Woman’s has been recognized as a Best Place to Work by Modern Healthcare – making us the only healthcare organization to earn the distinction every year since the program’s inception. We are proud of the level of care our staff provides to our patients and each other.If you have any questions or would like to connect with one of our recruiters directly, please e-mail
hrjobs@womans.org.We are an equal opportunity employer and value diversity and inclusion at Woman’s Hospital. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
#J-18808-Ljbffr