St. John’s Episcopal Hospital is the only hospital providing emergency and ambulatory care to the densely populated, culturally and economically diverse, and medically underserved populations of the Rockaways and Five Towns in southern Queens County and southwestern Nassau County, New York. Celebrating over 110 years of community care, the 257-bed facility provides people of all faiths with comprehensive preventive, diagnostic treatment and rehabilitative services, regardless of ability to pay.
Come Grow With Us!
Type: Full-Time
Shift: Days
Hours: 8:00AM – 4:30PM
Pay: $89,250 - $105,000
Job Summary:
The Charge Master Manager is responsible for the formulation and maintenance of the Charge Description Master in order to optimize revenue generation and maintain compliance with third party requirements and Price Transparency regulations. The incumbent supports clinical areas throughout the hospital in charge identification. Duties include serving as a contributing member of the Revenue Cycle team; maintaining Charge Description and Room & Bed master profiles; working with revenue generating departments and Information Technology to ensure ongoing coordination of the Charge Master compared to the Service Master and Room & Bed Master; ensuring accurate descriptions, CPT/HCPCS coding, additions, deletions, pricing, and any other changes are accounted for and included; maintaining a working knowledge of revenue cycle processes to aid in the implementation of regulatory standards that assist the health system in cash collection and compliance with billing guidelines; maintaining and ensuring timely turnaround of all Charger Master Requests according to hospital policies and procedures; monitoring facility charging mechanisms and systems to ensure correct processing for accurate billing; participating in activities that promote adherence to federal healthcare program requirements; adhering to the requirements of HIPAA Privacy Policies and Procedures; performing other duties as assigned.
Responsibilities:
- Evaluate the impact of innovations and changes in programs, policies, and procedures relative to the capture of charges for services rendered and related coding, classification, and pricing
- Design and implement systems and methods to improve charge integrity and charge capture compliance
- Identify, assess, and resolve issues impacting the charge capture, documentation, and related revenue cycle processes while providing guidance to charge capture workflows
- Keep the Charge Description Master (CDM) current and accurate with regard to changes requested by clinical and ancillary departments and pricing updates
- Make timely updates to the CDM when new regulations are published and coordinate their implementation with changes to the responsible department managers
- Assist and guide resolution of NCCI, OCE, and MUE Billing Edits; requiring in depth knowledge of revenue codes, CPT/HCPCS Level II codes, billing and coding edits, and billing reimbursement practices
- Manage upgrades, user troubleshooting, and perform administrative responsibilities for the facility setup and maintenance for CDM/charging/pricing software programs
- Educate departments and providers with respect to the use and maintenance of the charge master and charging philosophy
- Oversee, coordinate, and maintain Price Transparency requirements for the health system
- Oversee, coordinate, and maintain the Financial Assistance Program policies and procedures
- Audit system reports to address charging issues
- Develop and maintain documentation on charge master data management, pricing, and price transparency processes and procedures
Requirements:
- Associate's Degree in Healthcare Administration, Business Administration, or related field required; Bachelor's Degree preferred
- Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required
- Experience with coding systems such as ICD-10-CM/PCS, CPT-4, HCPCS Level II, and/or Medical Billing Codes
- Experience with billing and claims management systems in a hospital setting, Meditech preferred
- Knowledge of Medical Terminology, Anatomy, and Physiology
- 2-3 years experience in a healthcare or medical billing setting, charge master data experience preferred
- Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and Google Suite (Google Sheets, Google Docs)
- Familiarity with healthcare industry regulations governing privacy, billing and reimbursement, pricing, and price transparency
- Excellent analytical, organizational, and communication skills
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