Senior Charge Master Analyst

This is a Full Time (80 hours every two weeks) benefited and salaried position. Located at Scripps Corporate offices in San Diego.

Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide.

Why join Scripps Health?

AWARD-WINNING WORKPLACE:

• #5 in Fortune Best Workplaces in Health Care 2023
• #78 in 2023 PEOPLE Companies that Care
• #95 in Fortune 100 Best Companies to Work for 2023
• Recognized by Newsweek as one of America's Greatest Workplaces for Diversity in 2024
• Nearly a quarter of our employees have been with Scripps Health for over 10 years.

The Chargemaster Senior Analyst provides assistance and analysis to all levels of clinical management at Scripps in support of suggested requested and or mandated changes to the Charge Description Master CDM. This support includes development of data analysis and recommendations to minimize negative effects of change. Maintains the Scripps Health facility chargemasters within applicable coding guidelines and Scripps Policies and Procedures assists with bill problem resolution and researches and communicates coverage guidelines for billable services. Works with clinical directors and managers to implement and monitor CDM changes. Provides other support to the Manager Chargmaster as needed.

CDM responsibilities include but are not limited to:

• Monitors and maintains hospital departmental chargemasters to ensure coding and billing accuracy of new and existing service codes.
• Working with clinical directors and managers to implement and monitor CDM changes. Evaluates department requests to insure that all additions, changes and deletions are consistent with proper charging coding practices.
• Working with clinical directors and managers to insures the appropriate bundling or unbundling of charges so that all charges are submitted to result in appropriate reimbursement while following applicable billing reimbursement regulations.
• Developing reports to monitor compliance with department recommendations. Assists the Patient Financial Services billing personnel in resolving third party payor billing problems.
• Working with the Scripps contracting department and third party payors to resolve problems.
• Participating in the pre contract review process to insure that all billing requirements can be met.
• Working with Medicare intermediaries and CMS to clarify billing requirements.
• Documenting and tracking all communications and instructions received from government agencies. Communicates this information to all applicable departments.
• Reviewing all Medicare and Medi Cal newletters updates performs periodic review of the CMS Medicare fiscal intermediary web sites to keep abreast of pending changes.
• Working with the Chargemaster Steering Committee and affected departments to proactively creates plans to adopt and or implement changes.
• Reviewing Medicare intermediary Medi Cal California Workers Compensation and other third party payor bulletins to keep current on billing requirements.
• Communicating this information to all applicable departments through each facility's chargemaster task force team.

Senior Analysis duties include but are not limited to:

• Initiating develop and establish facility specific and regional models for financial analyses as related to requested and mandated changes to the chargemaster.
• Developing reports to evaluate the reimbursement effect of third party payor contract proposals as requested by the facility Fiscal Directors and or financial analysts.
• Providing analytical support related to reimbursement and billing to facility Fiscal Directors and or financial analysts.
• Developing implements and monitors the chargemaster database systems which enable corporate wide management reporting on financial and operational data.
• Providing analyses for corporate level reimbursement projects as requested by the facility's Fiscal Director Financial Analyst or PFS Management.
• Creating concise relevant accurate financial and statistical data in support of finance projects as requested.

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Required Education/Experience/Specialized Skills:-

• Five years experience in a chargemaster or revenue integrity related role;
• OR - Three years related experience with one of the following: Coding certification (CCS, CPC, CPC-H, RHIT, RHIA)
• OR Bachelors' Degree (preferred in health-care related field, business, finance or accounting)
• OR Associates Degree or Health Care Professional License (i.e. nursing, radiology, respiratory therapy)
• Demonstrate knowledge of procedural coding for Medicare, Medi-Cal and California Workers Compensation in an acute care and or professional setting.
• Knowledge of CPT/HCPCS coding and revenue coding required. -
• Advanced working knowledge of Microsoft Office Programs (Word, Excel, Access, PowerPoint), and other software for researching issues concerning CDM maintenance. -
• 3 years experience working in an EMR system (Epic)
  

Preferred Education/Experience/Specialized Skills/Certification:

• Coding Certification CPC, CPC-H (AAPC) or CCS (AHIMA) preferred.