CHARGE MASTER ANALYST - Health Information Dept (HIM) - Full Time - Days - Onsite

Charge Master Analyst - Full Time

Shift: 8:00am - 4:30pm

NOTE THIS IS AN ONSITE POSITION - NOT REMOTE. 

Job Description:

PATIENT POPULATION:
The patient population served can be all patients including geriatric, adult, adolescent, pediatric, and newborn. This also includes services which affect facility staff, physicians, visitors, vendors and the general public.

POSITION SUMMARY:
Reporting to the Department Leader, the Charge Master Analyst is responsible for maintaining and optimizing the hospital's Charge Description Master (CDM) to ensure accurate, compliant, and complete charge capture and pricing across all inpatient, hospital-based outpatient, and ambulatory service areas. The CDM Analyst serves as a subject matter expert and liaison between clinical departments, Coding, Billing, Compliance, Finance, IT, and Materials Management to support correct charging, appropriate reimbursement, and adherence to regulatory and payer requirements.

Must be able to work normal/scheduled working hours to include Holidays, call-backs, weeknights, weekends, and on-call. Agrees to participate, as directed, in emergencies and community disasters during scheduled and unscheduled hours. As a designated disaster service worker you are required to assist in times of need pursuant to the California Emergency Services Act.
(Gov’t. Code §§ 3100, 3102)

Needs to recognize that they have an affirmative duty and responsibility for reporting perceived misconduct, including actual or potential violations of laws, regulations, policies, procedures, or this organization’s standards/code of conduct.

The employee shall work well under pressure, meet multiple and sometimes competing deadlines; and the incumbent shall at all times demonstrate a cooperative behavior with colleagues and supervisors.

EDUCATION/TRAINING/EXPERIENCE:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

To perform this job successfully, an individual must have a minimum of 3-5 years of experience in hospital revenue cycle, charge master maintenance, coding, billing, patient accounting, or revenue integrity. Prior hands-on experience with CDM Management or charge capture strongly preferred. Experience working with reimbursement methodologies (Medicare OPPS, APCs, DRGs), and payer billing requirements. Associate or bachelor's degree in business, health information management, healthcare administration, accounting, finance or related field preferred.

Demonstrated knowledge of federal and state billing requirements and compliance issues.

The individual is self-directed and demonstrates ability to work independently with little or no supervision. The individual will also posses advanced critical thinking and problem solving skills.

Ability to read and interpret documents such as Federal and State (Medicare and Medi-Cal) bulletins, notices, and official documents, and apply changes to the Charge master and charging processes as appropriate. Ability to write routine reports and correspondence if required. Effective oral and written communications are integral to the position.

Clear, accurate and detailed documentation of policy and process changes, training guides, major system changes, etc. for historical reference is a requirement.

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages if required.

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Requires significant capacity to manage multiple competing objectives and to communicate complex technical information in understandable terms to management and other personnel of Sierra View Medical Center.

To perform this job successfully, an individual should have strong advanced MS Excel and data manipulation skills.

LICENSURE/CERTIFICATIONS:
N/A

Responsibilities and Essential Functions:
*Indicates Essential Function

1 * Maintain the CDM, including the creation, modification, inactivation, and deletion of CDM line items. Ensure each charge has appropriate CPT/HCPCS, modifiers, revenue code, description, pricing, units, and any required flags or indicators. Coordinate routine and ad hoc CDM reviews with departments, tracking requested changes form intake thorugh approval and implementation in coordination