St. Mary's Health Care
Chargemaster Specialist
St. Mary's Health Care, Amsterdam, NY, United States
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.
- 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.
• 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
- 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.