Sr. Chargemaster Specialist

JOB SUMMARY:
Maintains an accurate and complete chargemaster and performs data analysis, audits, information queries, and other special projects to optimize revenue generation and maintain coding compliance, independently.


KEY RESPONSIBILITIES:

• Monitors and approves all changes made to charges through the review process.
• Assists with standardizing charge capture processes and analyzes charge requests for new procedures, supplies, and pharmaceuticals.
• Performs queries of data to assist in the resolution of billing and coding questions.
• Provides education on procedures to maintain charge and reconciliation processes that are compliant.
• Performs timely updates of the chargemaster in alignment with regulatory guidance.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES:

CODING KNOWLEDGE (INTERMEDIATE): - Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.

REVENUE CYCLE (INTERMEDIATE): - Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

REGULATORY COMPLIANCE (INTERMEDIATE): - Demonstrates knowledge of the appropriate rules and regulations and apply them in difficult, stressful and complex situations. Able to interpret and explain rules and regulations that are ambiguous or unclear. Directs others in interpreting rules and regulations on the job and trains others in them.

PROBLEM SOLVING (INTERMEDIATE): - Uses critical thinking and process improvement i.e. coaches and mentors development of problem statement, describes current state, identifies root causes, creates future state, coaches and mentors development of solutions and action plans with a sustainability plan. Applies appropriate tools to address issues.

CORE ACCOUNTABILITIES:

• Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams.
• Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution.
• Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas.
• Team Interaction: Acts as a go-to resource for colleagues with less experience; may lead small project teams.