Senior Systems Analyst, Chargemaster; Onsite, Hybrid, Remote

Job Description

At North Bay Healthcare the Senior Systems Analyst, Chargemaster is responsible for ensuring a compliant Charge Master (CDM) data file and for the maintenance of the files within all affected software applications. Responsible for maintaining Chargemaster compliance in accordance with regulatory guidelines.

The Senior Analyst serves as a liaison between Finance and all clinical hospital departments including hospital based clinic departments, providing expert guidance on all Chargemaster related issues. Acts as an application and subject matter expert and resource for System Managers in the area of Chargemaster related issues.

Serves as a leader in Charge Master meetings and related projects. Conducts and/or oversees data entry of Charge Master revisions. Directs Chargemaster training sessions for System staff as needed. This role involves actively participating in and leading Chargemaster meeting, projects, overseeing data revisions, and directing training sessions for system staff to maintain regulatory compliance and optimize revenue integrity.

• Manages the charge master’s long term integrity, including pricing for CPT and HCPC codes. Manages all updates and modifications to the CDM
• Serves as the lead subject matter expert for Chargemaster pricing during annual reviews.
• Manages charge master configurations across all relevant software applications
• Drives cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant charge master across all integrated systems.
• Drives the timely implementation for all annual CPT, HCPCS, and modifier updates ensuring organizational readiness and regulatory compliance for charge master data.
• Develops and implements comprehensive policies, procedures, tools and forms to support efficient charge master maintenance.
• Accountable for the integrity of the charge master compliance, including all auditing and quality assurance activities.
• Facilitates cross-functional meetings with key stakeholders including patient financial services, information systems, health information management and clinical departments to proactively analyze error reports, audit findings and regulatory updates. Ensures the ongoing accuracy and compliance of the charge master.
• Follow up on outstanding issues and tasks, facilitating meeting with relevant hospital department and administrative representatives to implement necessary corrections. Escalates issues to the Manager, Revenue Integrity as appropriate.
• Ensures ongoing billing compliance by reviewing billing manuals and regulatory requirements with staff and relevant hospital departments and by providing continuous education to adhere to all contractual and regulatory stipulations.
• Leads preparation, education, implementation and ongoing monitoring of changes to APC’s, DRG’s and all payer fee schedules. This includes researching complex reimbursing issues and collaborating directly with department directors to ensure seamless adaptation and compliance.
• Oversees charge master compliance initiatives, collaborating closely with the compliance office to monitor investigatory activities and findings that relate to billing charge master data.
• Manages and submits all the required HCAI CDM information, ensuring timely file submission in accordance with regulatory timelines.
• Develops new CDM item and service pricing strategies informed by market and competitor research.
• Provides monthly CDM updates to the organization. Manages the maintenance of CDM software applications.
• Manages the annual pricing strategy project, overseeing all activities from planning to the implementation of revisions.
• Collaborates with IT and relevant department to optimize the efficiency and functionality of charge services activities interfaces.
• Develop and deliver training on batch charge entry procedure to relevant users.
• Provides regular updates to Manager, Revenue Integrity.
• Enhances professional growth and development through educational programs, seminars, etc.

Perform regular department audits to maximize and ensure the accuracy of charge capture.

• Education :
  Bachelor’s Degree in…