Analyst – Charge Master
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Job Description
Revenue integrity analyst managing hospital charge capture, audits, and payer compliance for Northeast Georgia Health System. Maintaining charge masters and supporting clean claims.
Responsibilities:
- Assess, coordinate and manage charge capture and reconciliation processes from charge creation through clean claim submission
- Improve revenue management and ensure charge capture process integrity
- Collaborate with revenue cycle and department leadership to meet regulatory requirements
- Coordinate new services and products for revenue cycle purposes
- Identify, review and build charges within the EMR and CDM
- Select appropriate charge generation models
- Maintain a compliant charge description master file
- Conduct routine charge capture audits and implement suggested changes
- Interact with clinical and ancillary departments to ensure charge codes accurately reflect services
- Lead reviews and maintenance of Hospital and Physician Charge Masters
- Monitor changing industry requirements, regulations, fraud alerts and advisory opinions
- Coordinate communication regarding regulatory or payer changes with impacted leaders
- Investigate and advise on professional/technical billing, coding and regulatory documentation requirements
- Assess audit and monitoring trends and coordinate mitigation activities
- Research third-party payer regulations and ensure compliance with federal, state and local payer regulations and hospital contracts
- Participate on committees as assigned
- Perform other duties as assigned
Requirements:
- Certification in healthcare compliance (HCAA or AAPC's certification) and/or Coding Certification (RHIA, RHIT, CPC or CCS)
- Minimum five (5) years demonstrated administrative skills in Coding, CDM/Charge Master, Finance, or medical records
- Demonstrated experience working with hospital charging processes
- Extensive experience/knowledge in revenue cycle processes
- Extensive experience in effective problem-solving skills, project management skills, and conflict resolution skills
- Preferred: Bachelor's Degree from an accredited college or university in Healthcare Administration
- Preferred experience with APC reimbursement, CMS rules and regulations, coding and billing compliance
- Working knowledge of OPPS, HCPCS and CPT-4 coding schemes
- Experience in multi-hospital organizations
- Epic experience
- Ability to incorporate regulatory requirements and perform data input, analysis and QA
- Ability to interpret, analyze, develop, direct and implement large-scale implementations and projects
- Ability to identify and redesign inefficient workflows and processes
- Excellent written and verbal communication skills, including conflict resolution
- Strong interpersonal skills
- Superior analytical and problem-solving skills
- Ability to work independently or with minimal supervision
- Excellent analytical skills for pricing, revenues and reimbursement analysis
- Excel and/or Access proficiency
Benefits:
- Equal Opportunity Employer
- Opportunities to reach personal and professional goals
- Team investment in employees as people
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