Chargemaster 2

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: System Chargemaster Specialist II

REPORTS TO POSITION: System Revenue Integrity Manager

DEPARTMENT: Revenue Integrity

DATE LAST REVIEWED: August 2024

OUR VISION: Creating Americas healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver a delightful, transparent and seamless experience to our patients and customers that captures and collects the revenue earned by SCHS in a quality, efficient and timely manner.

POSITION OVERVIEW: The System Chargemaster Specialist II at St. Charles Health System develops, maintains, and reports on the facility chargemaster and clinic fee schedule, ensuring data integrity between the chargemaster/fee schedule and each departments/clinics charges. Additional responsibilities include researching coding and revenue reporting requirements, ensuring the accuracy of pricing structures and codes as required by SCHS, local, state, and federal regulations. This position does not directly manage other caregivers, however may be asked to review and provide feedback on the work of other caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Maintains the chargemaster/fee schedule by incorporating new charges/services identified by departments, clinics, third-party changes, special requirements and coding updates.

Coordinates and performs a detailed, annual review of the chargemaster/fee schedule, which includes identifying codes that have been deleted, added, or replaced; identifying description changes; and ensuring nomenclature reflects the procedures/services performed.

Identifies services that are reimbursable but are not being coded; reviews, assigns, and validates revenue codes.

Maintains an audit trail of chargemaster changes; communicates these changes to administration and the hospital departments and medical group clinics that will be impacted.

Researches and resolves CPT code, revenue code, and other issues.

Supports clinical areas and departments in charge capture, coding accuracy, and revenue management in order to ensure organization-wide uniformity of charges and coding for similar services and procedures.

Identifies/investigates issues with medical necessity, coding, and billing that reduce reimbursement; recommends action steps and works collaboratively with the departments and clinics to improve processes when operational weaknesses and/or compliance issues are found.

Coordinate and maintain organization-wide charge sheets created by departments and clinics.

Serves as a back-up to the Chargemaster Coordinator.

Responsible for training, audit, and continued education to Chargemaster Specialist I.

Completes and provides management reports as requested.

Supports the vision, mission and values of the organization in all respects.

Supports Value Improvement Practice (VIP- Lean) principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the organizations corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate.

May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION

Required: Associates Degree in related field or a minimum 3 years equivalent work experience and similar successful experience that may be substituted for an Associates Degree is required.

Preferred: N/A

LICENSURE/CERTIFICATION/REGISTRATION

Required: N/A

EXPERIENCE

Required: Experience in health information management (HIM), healthcare financial management, or information systems required. Ability to understand health care insurance billing guidelines required. Experience with medical terminology and CPT4 required.

Preferred: Experience maintaining price files and record keeping preferred.

PERSONAL PROTECTIVE EQUIPMENT

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Skills:

Communication/Interpersonal

Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS.

Ability to effectively interact and communicate with all levels within SCHS and external customers/clients/potential employees

Strong team working and collaborative skills.

Ability to effectively reach consensus with a diverse population with differing needs.

Ability to work under pressure in a fast-paced environment.

Organizational

Ability to work independently.

Attention to detail.

Excellent organizational skills, written and oral communication and customer service skills, particularly in dealing with stressful personal interactions.

Strong analytical, problem solving and decision making skills.

Excellent organizational and multi-tasking skills.

Mathematical Skills:

Performs intermediate to advanced math (analysis, statistics, significant data or number manipulation).

Computer

Intermediate to advanced proficiency in Microsoft applications (Word, Excel and Access), database management, and document preparation.

Strong data entry skills; ten-key required.

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.

Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.

Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors

Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category

No Risk for Exposure to BBP

Schedule Weekly Hours:

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