General InformationPress space or enter keys to toggle section visibility
Work Location: Los Angeles, CA, USAOnsite or Remote Flexible Hybrid
Work Schedule Monday-Friday, 8:00am-5:00pm
Posted Date 04/10/2024
Salary Range: $86400 - 184800 Annually
Employment Type 2 - Staff: Career
Duration Indefinite
Job # 18221
Primary Duties and ResponsibilitiesPress space or enter keys to toggle section visibility
You can be part of the team responsible for building and maintaining charge master records for the hospital system. You'll ensure that hospital charges are processed promptly, accurately, and in compliance with Centers of Medicare & Medicaid Services (CMS), Medi-Cal, and other policies. You'll apply your extensive knowledge of hospital billing, coding, and pricing practices, as well as advanced data analysis skills, to monitor, maintain, and improve the charge master records. You will:
- Develop and maintain charge codes and prices in partnership with ISS CareConnect teams and Operational Departments.
- Investigate and resolve suspended charge records from CareConnect hospital billing work queues assigned to the Charge Description team.
- Create new charge records as needed for new CareConnect applications. Participate in developing testing scenarios. Validate testing procedures to ensure that new workflows generate charges properly.
- Conduct quarterly, annual, or as-needed reviews to ensure that the Charge Description Master is updated for new and revised CPT4/HCPCS codes.
- Comply with the Charge Master Department's policy and procedures related to charge codes and descriptions.
- Effectively coordinate and facilitate user interaction with CareConnect teams to define and validate processes that assure effective and efficient charge flows.
- Maintain files that contain the audit trail of Charge Description Master additions, updates, and other changes.
- Collaborate with the Revenue Capture, Revenue Integrity, and HB teams on the routine review of charge capture processes.
- Manages and conducts special project reviews.
- Maintain compliance with CMS, Medi-Cal, and health plan billing regulations.
- Analyze complex billing/financial data.
- Summarize data and present findings to leadership.
Salary Range: $83,800-$179,400/annually
Job QualificationsPress space or enter keys to toggle section visibility
We're seeking an adaptable, knowledgeable, and highly analytical individual with:
- CCS, CPC-O, CPC certification or related coding education
- Bachelor's degree in business, finance, or related field, preferred
- Eight or more years of experience in hospital finance, billing, coding, revenue integrity, medical analysis, or medical auditing
- Prior experience and/or knowledge of regulations on charging and billing practices for Medicare, Medi-Cal, and other payers (UB04 and/or CMS1500)
- Experience with EPIC charge master and familiarity with CDM structure, content, and maintenance, as well as in revenue integrity operations, clinical charge capture, or revenue cycle operations
- Knowledge of CPT, HCPCS, and Medi-Cal coding guidelines and regulations; ability to utilize relevant reference resources (e.g., Federal Register, CMS memorandums, etc.)
- Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes
- Understanding of compliance issues and their importance and consequences
- Knowledge of EPIC system, particularly Resolute Hospital Billing
- Advanced knowledge of Microsoft Office
- Experience with project processes and facilitation of teams
- Background in project management preferred.
- Strong analytical, problem-solving, communication, interpersonal, and collaboration skills
As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Current/former UC employees are subject to a personnel file review.
