| Primary City/State: Phoenix, Arizona Department Name: CDM Services-Corp Work Shift: Day Job Category: Revenue Cycle THIS IS A FT BENEFITS ELIGABLE EMPLOYED POSITION - NOT A CONTRACT If you're looking to leverage your abilities to make a real difference - and real change in the health care industry - you belong at Banner Health. With facilities in six western states, we're committed to not only providing the finest care possible, but to advancing the way care is provided. To achieve our vision, we seek driven professionals who embrace change and who possess the passion and skills to make it happen. Charge Description Master Services maintains the chargemasters for all Banner hospitals and clinics. This is a strong group of folks that function at the team level, working hard and supporting each other daily. The Charge Description Master is a critical revenue integrity position that maintains a compliant charge master and provides charge education to ancillary areas. This individual will maintain over 1 million-line items and must be able to manage data using advanced Excel skill including excel lookups and pivot tables. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY
This position develops and maintains all patient charges for the organization, as well as identifies, audits, and resolves coding concerns, charging issues, and related operational practices for organizational entities ensuring federal, state, local regulatory and managed care compliance.
CORE FUNCTIONS
1. Implements and maintains all changes, additions, and deletions for any charge description master revision to ensure federal and state compliance and to avoid possible severe penalties and maintain the integrity of the organization's Enterprise Standard Charge Description Master. Makes recommendations and operationalizes changes as needed. Checks formulas for applicable departments. Completes and implements price changes. Provides information regarding the development of charge description masters for new departments or service lines
2. Conducts internal reviews of the charge description master coding and charging practices. Identifies and resolves any issues. Provides education and training, making decisions and determinations regarding appropriateness of changes. Educates and trains personnel to ensure compliance and avoid fraud and abuse issues. Acts as a resource for corporate compliance. Prepares and operationalizes policies and procedures as identified by external sources.
3. Identifies the departments impacted by the annual CPT-4/HCPCS and UB04 code revisions (additions, deletions, changes, as well as other regulatory language changes). Provides information and recommendations as needed. Ensures timely updates to the charge description masters (coordinating with each applicable department at each facility) to avoid patient account denials.
4. Audits departments' charge description masters to ensure that all patient charges are included, accurate, and complete. Communicates government payor reimbursement information for related charges to managed care for use in contract negotiations. Completes and submits state rate filing package and any revisions working with facility finance to ensure state compliance. Analyzes overall impact system wide and reports to managed care.
5. May participate in strategic pricing projects to ensure appropriate patient charges while maintaining budgeted revenue. May also assist in analysis of system requirements, validation and maintenance with respect to the charge description master application.
6. This position works with all organizational entities. Requires the ability to work with a variety of personnel throughout the system, external auditors, federal and state government personnel and Medicare Fiscal Intermediary, managed care, contracted payors, CMS and other regulatory agencies. Knowledge of the organization's data and interfaces are needed for obtaining reliable information.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager. MINIMUM QUALIFICATIONS
Must possess a strong knowledge of business, accounting and/or finance as normally obtained through the completion of a bachelor's degree in business, accounting, finance or related field.
Must possess a strong knowledge and background in healthcare billing, reimbursement and coding as normally demonstrated through four years of progressively responsible experience in billing, reimbursement and/or coding. Must possess a knowledge of managed care contract and government payor compliance and reporting requirements. Technical knowledge required of CPT-4/HCPCS and UB04 codes.
Excellent organization, oral and written communication skills, as well as ability to maintain highly confidential data.
PREFERRED QUALIFICATIONS
Registered Nurse (RN), Licensed Practical Nurse (LPN) or clinical experience and/or knowledge. Coding certification or an in-depth knowledge of medical coding.
Additional related education and/or experience preferred. |
