SR CHARGE MASTER ANALYST

About the role

The New Jersey Pay Transparency Act requires disclosure of the pay range for this position. A salary offer will vary based on the job role, candidate experience, qualifications, internal pay equity and market data.

Cooper University Health Care is an Equal Opportunity Employer and is committed to equal employment opportunity for all team members. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, or any other status protected by law or regulation.

Responsibilities

• Oversee Chargemaster maintenance for CUH to ensure proper revenue generation and reimbursement, improvement to all aspects of revenue cycle operation (coding, charge capture, and work processes), while maintaining compliance with third party and government requirements
• Manages processes for quarterly and annual CDM updates including tracking, review, analysis, departmental communication, soliciting internal responses, formatting changes to the CDM
• Helps analyze and identify root causes for charge edits, claim edits, denials relative to chargemaster settings. Develops and documents options for further discussion and implementation
• Works in coordination with Revenue Integrity staff as problems are discovered to help strategize changes needed in workflows, IT systems, interfaces due to CDM settings
• Implements charge strategy, coding, workflow, corrections and facilitates rebilling as necessary for the resolution of compliance, reimbursement or denial issues
• Develops anticipatory measures and solutions in response to patterns discovered through audit, analysis, review with department users
• Communicates, helps to develop, and conducts education to various departments regarding charging, coding, and billing errors that are identified
• Participates in internal and external audits focused on charge capture or CDM issues
• Capable of using spreadsheets, various billing and clinical source documents, Epic system, and other analytic tools to prepare and present investigative results
• Understands coding/ HCC and billing requirements to ensure compliance with all governmental and contractual obligations
• Prepares and maintains a variety of communications, tip sheets, reports, and records while ensuring confidentiality of financial and medical records
• Advises and instructs providers, department managers, end users regarding billing and documentation policies, procedures and regulations; interacts with Cooper University Health Care staff regarding incorrect charging, conflicting coding, ambiguous documentation, obtaining clarification of same and educate in regard to changes and measuring compliance

Requirements

• 5-7 years of healthcare experience with knowledge of hospital operations & payment systems. Prefer experience in Charge Description Master (CDM), coding, billing, clinical area
• Understanding of CDM methodology and various coding systems used in healthcare, financial management and reporting
• Understanding of healthcare computer software including EMR, billing systems, CDM tools such as Craneware or Code Correct
• Proven ability to strategize, communicate, develop, and conduct education to various staff levels regarding workflow, billing, charging, and coding errors that are identified
• Able to review, analyze, prioritize various healthcare regulatory bulletins, websites, quarterly updates for communication to the hospital facility

Qualifications

• Healthcare certification program - CPC, RHIT, or other healthcare clinical certification (Radiology, Respiratory Therapy, etc.)
• College degree, will consider significant work experience in exchange

Skills

• Proficiency in spreadsheets, billing systems, CDM tools, and Epic system
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team

Benefits

Cooper University Health Care offers a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.