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Chargemaster Analyst

Summary:

Responsible for the oversight of Charge Description Master (CDM), Billing, and Reimbursement analysis within the Revenue Management Department. Serve as a member of the Revenue Management team and subscribe to the vision, values and expectations of the Duke University Health System. 
  

Duties:

  • Responsible for the oversight of Charge Description Master functions and reimbursement analysis within the Revenue Management Department.
  • Responsible for the supervision and coordination of Chargemaster and Charge Capture process in researching coding and billing guidelines, researching insurance contracts, and updating hospital and professional Chargemaster and Charge Capture processes. 
  • Works with the revenue producing departments to ensure the ongoing coordinated and consistency with the Chargemaster and Charge Capture processes, including accurate descriptions, coding, additions, deletions, pricing, revenue code and any other changes. 
  • Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist in cash collection while accurately complying with billing guidelines. 
  • Work with Finance, Revenue Recognition and Performance Services Departments to perform applicable analyses to understand budget, net revenue change and labor impact of proposed Chargemaster changes. 
  • Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs and overall expense reduction. 
  • Disseminate CMS updates to health care providers as they relate to billing for drugs, implantable and/or other pass-through eligible items, ensuring the necessary changes are made to the entity specific Chargemaster and Charge capture updates within the time frame for accurate and compliant billing. 
  • Recommend policies and procedures which impacts charge capture and pricing practices. 
  • Responsible for revenue code and coding assignment for all new items or services 
  • Oversees the overall maintenance and use of the charge master tool utilized by the Revenue Management Department 
  • Advises and collaborates with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel and outside consultants to analyze, review and assess identified billing, coding, charging and compliance issues. 
  • Perform other related duties incidental to the work described herein.

Education and Experience:

  • Bachelor's degree in business, healthcare administration or a related field is required. 
  • Four years of related experience required. 
  • Coding certification is strongly preferred 
  • Proficient in the use of Microsoft Office Programs, including but not limited to: Excel, Word, Powerpoint, and Access. 
  • Knowledge of Siemens Invision, IDX and/or Meditech preferred. 
  • Extensive knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations and APCs. 
  • Must have a good understanding of the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget. 
  • Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology 
  • Ability to research complex coding and regulatory requirements. 
  • Strong analytical skills.
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