Chargemaster System Coordinator (Full-Time)

Typical pay range: $29. 95 - $41. 34

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: System Chargemaster Coordinator

REPORTS TO POSITION: Director of Revenue Integrity

DEPARTMENT: Revenue Integrity

DATE LAST REVIEWED: March 2022

OUR VISION: Creating America's healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver a delightful, transparent, and seamless experience to our patients and customers that captures and collects the revenue earned by SCHS in a quality, efficient and timely manner.

POSITION OVERVIEW: The System Chargemaster Coordinator at St. Charles Health System is responsible for oversight and maintenance of the facility chargemaster and clinic fee schedule within the hospital and medical group's revenue producing departments/clinics. The Coordinator acts as a liaison, problem solver and facilitator for chargemaster/fee schedule opportunities with administration, charge capture departments, HIM, UM, internal auditors, managed care, reimbursement, compliance, decision support, IT, finance, and centralized business office teams. This position ensures hospital and clinic charging practices are in compliance with SCHS, local, state, and federal regulations. The Coordinator also provides chargemaster maintenance and a more limited scope of support to our Epic Connect Business partners. This position does not directly manage any other caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Leads and oversees the day-to-day operations and workflows of chargemaster team. Assigns work/tasks as needed to the chargemaster specialists.

Maintains the chargemaster/fee schedule by incorporating new charges/services identified by departments, clinics, third-party changes, special requirements and coding updates.

Leads pricing transparency work group/committees, ensure annual public posting of chargemaster per regulatory guidelines. Approves, creates, validates charges, and maintains guest estimate templates built in EHR system for SCHS and connect partners.

Supports the connect team with chargemaster consolidation and implementation for new entities. Provides ongoing chargemaster maintenance support to Connect partners.

Oversees the detailed, annual review of the chargemaster/fee schedule, which includes identifying codes that have been deleted, added, or replaced; identifying description changes; and ensuring nomenclature reflects the procedures/services performed.

Identifies services that are reimbursable but are not being coded; reviews, assigns, and validates revenue codes.

Oversees the audit trail of chargemaster changes; communicates these changes to administration and the hospital departments and medical group clinics that will be impacted.

Researches and resolves CPT code, revenue code, and other issues that are either routed to work queues or are sent to chargemaster team directly.

Supports clinical areas and departments in charge capture, coding accuracy, and revenue management in order to ensure organization-wide uniformity of charges and coding for similar services and procedures.

Identifies/investigates issues with medical necessity, coding, and billing that reduce reimbursement; recommends action steps and works collaboratively with the departments and clinics to improve processes when operational weaknesses and/or compliance issues are found.

Provides guidance on chargemaster setup needs during EHR implementations and provides education for end users on charging procedures.

Provides ongoing training, as well as guided direction for Chargemaster Specialist's I & II.

Completes, analyzes, and provides management reports as requested.

Serves as a resource for chargemaster guidance to the Revenue Strategy and Pricing Committee.

Conducts all activities with the highest standards of professionalism and confidentiality.

Complies with all applicable laws, regulations, policies, and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all company investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.

Supports the vision, mission, and values of the organization in all respects.

Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.

May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION:

Required: Associate's degree in a related field. A minimum of three (3) years work experience in revenue integrity or chargemaster may be substituted for a degree.

Preferred: Bachelor's Degree in a related field.

LICENSURE/CERTIFICATION/REGISTRATION:

Required: CPC, CPC-H, CCS, RHIT, RHIA, CHRI or Clinical licensure (e.g. EMT, RT, etc.).

Preferred: N/A

EXPERIENCE:

Required: Minimum one (1) year in a chargemaster role. Extensive knowledge of complete hospital/clinic revenue cycle process. Ability to understand health care insurance billing guidelines. Comprehensive knowledge of medical terminology and CPT4. Strong research skills on government, payer, and medical device product websites.

Preferred: Two (2) years' experience using Epic.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Skills:

Communication/Interpersonal

Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS.

Ability to effectively interact and communicate with all levels within SCHS and external customers/clients/potential employees.

Strong team working and collaborative skills.

Ability to effectively reach consensus with a diverse population with differing needs.

Ability to work under pressure in a fast-paced environment.

Organizational

Ability to work independently.

Attention to detail.

Excellent organizational skills, written and oral communication and customer service skills, particularly in dealing with stressful personal interactions.

Strong analytical, problem solving and decision-making skills.

Excellent organizational and multi-tasking skills.

Mathematical Skills:

Performs intermediate to advanced math (analysis, statistics, significant data, or number manipulation).

Computer

Advanced proficiency in Microsoft applications (Word, Excel, and Access), database management, and document preparation.

Strong data entry skills; ten-key required.

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.

Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.

Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors

Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category

No Risk for Exposure to BBP

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