You’ll need
Certifications
✓CCS, CPC-O, CPC certification or related coding education
Education
✓Bachelor's degree
Bachelor's degree in business, finance, or related field, preferred
Qualifications
✓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
✓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 project processes and facilitation of teams
✓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
✓Strong analytical, problem-solving, communication, interpersonal, and collaboration skills
Background in project management preferred
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About the role
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.