Revenue Integrity Chargemaster Analyst

Revenue Integrity Chargemaster Analyst 26202

Maintains the integrity of the Chargemaster and ensures all charging information including pricing, HCPCS/CPT codes and descriptions, and revenue codes are current and compliant with payer requirements. Ensures the CDM is built and maintained in accordance with government and industry regulations. In partnership with director and controller, acts as the organizations primary subject matter expert for the Chargemaster as it relates to annual pricing reviews, analysis, and pricing update recommendations, ensuring annual updates are published to maintain compliance with federal price transparency regulations.

Responsible for charge description master development, maintenance, and CDM comparative reimbursement analysis for hospital and professional charging across the organization Reviews and initiates all changes, additions, or deletions to the CDM, overseeing the work of others as necessary Ensures accuracy of clinical charges, descriptions and billing codes in the Chargemaster Leads hospital departments and IT staff in the formulation of a strategy for an efficient and compliant Chargemaster within all software applications Prepares the organization for timely implementation of annual coding updates (CPT, HCPCS), including modifier revisions and regulatory updates related to Chargemaster data Creates internal policies, procedures, tools, and forms for Chargemaster maintenance Compiles and analyzes clinical, competitor and payer charge and reimbursement data necessary to prepare recommendations advantageous to the company for pricing and charging, presenting recommendations to leadership as requested Regularly prepares CDM and payer reimbursement reporting, based on charge patterns and CDM change recommendations Monitors organizational charging and billing patterns and ensures accurate cross-walk of charge master details with underlying clinical systems used for charge capture and clinical documentation Conducts quarterly audits of the CDM to support accuracy and quality of hospital revenue Conducts periodic meetings with departments to analyze error reports, audit information and regulatory changes to assure continued accuracy of CDM.

Facilitates meetings and documents questions, issues and follow-up tasks. Implements corrects and resolves outstanding issues, escalating to leadership as needed Monitors CDM maintenance for updates to assure compliance to price transparency Monitors compliance initiatives related to Chargemaster data, working closely with the Compliance Officer to monitor compliance investigatory activities and published findings, which may be correlated to Chargemaster billed data Develops pricing recommendations for new CDM items and services based on pricing research involving local peer group and other appropriate hospitals Ability to manage multiple priorities and to meet established project deadlines Performs other related duties as assigned Maintain high productivity and quality with minimal supervision Relies on experience and judgment to plan and accomplish goals Regular and predictable attendance is an essential job function Competent to meet age specific needs of the unit assigned Requirements and

• Bachelor’s degree in related field required; 6 years’ directly related experience in a Revenue Integrity role may be accepted in lieu of degree 2 years’ of responsible CDM (Chargemaster and fee schedule) experience preferred Experience in physician (professional) and hospital financial or revenue cycle operations required Coding certification from AAPC or AHIMA preferred Completion of medical terminology class preferred Experience collaborating in inter-disciplinary workgroups and building effective working relationship with all levels of staff and leadership Demonstrated knowledge of CMS regulations governing hospital and professional coding and billing required Experience working in an Epic or similar EMR with equivalent applications preferred Previous process improvement experience preferred Working Conditions: Must be able to maintain a sitting position Typical equipment used in an office job Repetitive movements Remote eligible About Kootenai Health: Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider. As your next employer, we are excited to offer you: Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1 st of the month following 30 days of employment. Kootenai Health’s tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3
• 6 percent. Competitive salaries with night, weekend, and PRN shift differentials An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching Employees receive discounts at The Wellness Bar, PEAK Fitness, and more Robust and interactive employee referral program And much more Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Please contact the HR Front Desk at 208
• 625
• 4620 or email careers@kh.org with any questions. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.