Senior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)

About the role

The Senior System Specialist, Chargemaster plays a crucial role in ensuring a compliant and accurate Chargemaster across NorthBay Health. This individual serves as an expert and liaison between finance, clinical departments, and hospital-based clinics on all CDM matters. They actively drive and assist compliance by overseeing system data revisions, participating in high-priority CDM projects and meetings, and assisting in the development and delivery of training sessions for system staff.

Responsibilities

• Manages the chargemaster’s long term integrity, including pricing for CPT and HCPC codes.
• Manages all updates and modifications to the CDM.
• Affords assistance with chargemaster configurations across all relevant software applications.
• Assists with cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant chargemaster across all integrated systems.
• Develops and implements comprehensive policies, procedures, tools and forms to support efficient chargemaster maintenance.
• Affords assistance with chargemaster compliance, including all auditing and quality assurance activities.
• Assists with cross-functional meetings with key stakeholders including patient financial services, information systems, health information management and clinical departments to proactively analyze error reports, audit findings and regulatory updates.
• Follows up on outstanding issues and tasks, facilitating meetings with relevant hospital department and administrative representatives to implement necessary corrections.
• Escalates issues to the Manager, Revenue Integrity as appropriate.
• Affords assistance with ongoing billing compliance, reviewing billing manuals and regulatory requirements with staff and departments as needed.
• Leads preparation, education, implementation and ongoing monitoring of changes to APC’s, DRG’s and all payer fee schedules. This includes researching complex reimbursing issues and collaborating directly with department directors to ensure seamless adaptation and compliance.
• Affords assistance with chargemaster compliance initiatives, assists with any investigatory activities and findings that relate to billing chargemaster data.
• Affords assistance with the maintenance of CDM software applications.
• Collaborates with IT and relevant department to optimize the efficiency and functionality of charge services activities interfaces.
• Affords assistance with training on batch charge entry procedure to relevant users.
• Provides regular updates to the Revenue Integrity manager.
• Enhances professional growth and development through educational programs, seminars, etc.
• Performs regular department audits to maximize and ensure the accuracy if charge capture.

Qualifications

• Bachelor’s degree in computer systems, Business, Nursing or 8 years of experience in Revenue Cycle Management required.
• Minimum five years of hospital business office experience, or three years of clinical patient care with two years of medical business office experience required.
• Two years of hospital Medicare billing experience strongly preferred.
• Experience with interfaces required.

Skills

• Strong organizational and meeting facilitation skills.
• Strong project management capabilities.
• Ability to read and interpret regulatory information related to billing of CDM data.
• Proficient in MS office applications, especially Excel, PowerPoint, Word and Access.
• Knowledge of internet and government websites required.
• Interpersonal Skills: Demonstrates the True North values.

Standards of Performance

• Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.