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Charge Master Specialist

Work Schedule/Days:  Day / Monday - Friday
Employment Type:  Full-Time
Location:  Office Park (1455) 
Requisition #:  37507

 

JOB SUMMARY

The Charge Master Specialist enters charges and transaction codes requested by operational and financial leaders, updates charges as appropriate, and monitors charges and transaction codes established for appropriateness. Updates charge master as new and updated regulatory and contractual requirements are identified by Revenue Cycle, Reimbursement, and Operations. Maintains relationship with financial/operational staff engaged in pricing, charging, and reporting matters. Maintains close working relationship with Information System & Technology business partners and serves as subject matter expert on content of Epic system master files and functionality related to pricing and charging, e.g., EAP, Epic Resolute Hospital and Professional Billing, and other applications. Supports efforts that ensure delivery of safe patient care and services and promote a safe environment at Children's Healthcare of Atlanta.

EDUCATION
  • Bachelor’s degree in business, accounting, or finance
EXPERIENCE*
  • Two years of experience in healthcare provision in a reimbursement, financial accounting, billing compliance, or charge master role
PREFERRED QUALIFICATIONS*
  • Experience in Microsoft Access and SQL reporting
  • Experience in Epic and Lawson applications
KNOWLEDGE SKILLS & ABILITIES*
  • Demonstrated knowledge of healthcare pricing and charge master concepts
  • Demonstrated organizational and communication skills and ability to work with detailed financial information with accuracy and confidentiality
  • Demonstrated proficiency in Microsoft Office applications, e.g., Word, Excel, Outlook
  • Demonstrated critical thinking, communication, organizational, and interpersonal skills
JOB RESPONSIBILITIES*
  1. Maintains charge description master and coordinates Manager, Revenue Cycle with clinical departments to ensure that charges are assessed and appropriate for patient services provided.
    • Maintains charge description master structure, including appropriate and current HCPCS/CPT UB revenue coding assignment.
    • Inputs and verifies approval of new charge description master items.
    • Works to ensure pricing consistency across the organization with feedback from Finance and operational leaders.
    • Escalates compliance and reimbursement issues identified in existing charge master files as well as new requests.
  2. Assists in researching and resolving issues related to charging and billing for patient services.
    • Performs assessments of charging and billing compliance and reimbursement implications.
    • Resolves issues related to charges, charge structure, documentation, and charge reconciliation for patient services, coding, and billing compliance.
    • Coordinates with Patient Financial Services to ensure awareness and appropriateness of billing implications.
  3. Researches new and existing clinical services and projects.
    • Conducts research and interprets regulations and other requirements to determine charging and billing alternatives and compliance issues in conjunction with operational and Reimbursement staff members.
    • Determines feasibility, implications, and financial impact of reimbursement.
    • Provides assessments of reimbursement and collection impacts of changes requested.
    • Provides comparison of alternatives and recommendations to support establishment of properly structured charges and consideration of optimal operational implications.
  4. Facilitates appropriate charge capture and charge reconciliation.
    • Provides support and direction to clinical departments for process improvement in areas of charge capture and balancing.
    • Establishes and reviews edit reports and completes focused analyses and assessment to assess appropriateness of patient service charges and billings.
    • Coordinates training, communication, and activities related to the charge master with department manager, clinical departments, Patient Accounts, and Revenue Cycle support.
  5. Acts as a resource and reference for the system related to charges, charge compliance/capture, and reimbursement/collection impacts.
  6. Supports department manager in providing timely, informed response to clinical areas based upon department needs, regulatory changes, and response to requests for support.
  7. Provides support to Reimbursement department in addressing monthly revenue and revenue deduction assessments, special projects, and preparing all required reports and financial surveys for maximum appropriate benefit and third-party reimbursement.
  8. Ensures timely, accurate, and optimal reporting.
SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

 

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

 

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification.  They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*
Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Occasionally (activity or condition exists up to 1/3 of time)
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)
WORKING CONDITIONS*
No potential for exposure to blood and body fluids

 

About Us:

Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.

With 3 hospitals, 27 neighborhood locations and a total of 638 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 70 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.

Children’s has been ranked on Fortune magazine’s list of “100 Best Companies to Work For” for fourteen consecutive years and named one of the “100 Best Companies” by Working Mother magazine.  We offer a comprehensive compensation and benefit package that supports our mission, vision and values.  We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country.  Connect to our mission of making kids better today and healthier tomorrow. 

Have questions about the recruitment process?  Check out What to Expect.

Address:  1455 Tullie Circle NE, Atlanta, GA  30329
Function:  Revenue Cycle - Patient Financial Services


Nearest Major Market: Atlanta

Job Segment: EMR, Patient Care, SQL, Database, Pediatric, Healthcare, Technology