Chargemaster Revenue Cycle Specialist

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Management of Revenue and Reimbursement

• Ensures that charges are appropriately bundled or unbundled to facilitate maximum reimbursement while adhering to relevant billing, coding, and reimbursement regulations.

• Analyzes Medicare transmittals to assess the necessity of new codes, coding modifications, or directives affecting billing and compliance, and effectively communicates these updates to all pertinent departments.

• Proactively identifies new charge opportunities and provides monthly recommendations to mitigate future billing issues.

• Oversees the maintenance of the Chargemaster (CDM) process, including training and supervising staff to ensure timely processing of CDM requests, thereby reducing bill rejections and delays in payment due to coding and charging concerns.

• Effectively leverages all internal automation and software tools, preparing reports as required by management to suggest process improvements and address systematic claims processing challenges.

• Responds to inquiries regarding hospital and departmental operations, policies, and procedures.

• Assists Payer Relations with contract analysis to optimize reimbursement.

• Develops or modifies revenue and reimbursement reports to ensure a continuous revenue stream.

• Quality Assurance

• Protects the hospital from potential denials, penalties, and fines by ensuring that healthcare services are billed accurately and appropriately at all times.

• Coordinates and conducts analysis of annual charge change recommendations and pricing schedule adjustments proposed by contracted Revenue Consultants.

• Collaboration and Partnership

• Aids billing personnel in resolving third-party payer billing issues and collaborates with Department Managers, Business Office, HIM, and Managed Care to enhance charge capture, secure accurate payments from payers, and minimize claim denials.

• Supports departments in coordinating, compiling, and interpreting information related to healthcare services and operating expenses to foster efficient charging practices and capture appropriate revenue.

• Conducts in-house training concerning revenue cycle indicators for Department Managers.

• Other Duties as Assigned

• Performs additional duties as assigned or requested.

⛳️ Requirements

• A minimum of 5 years of experience in facility chargemaster operations.

• A Bachelor's Degree in Business, Finance, Accounting, or a related medical field, or a degree or certificate in nursing.

🏝️ Benefits

• None specified