Develops, maintains and provides guidance related to charge capture workflows and processes for Montefiore Medical Center and New Rochelle/Mount Vernon. Researches coding and revenue reporting requirements; Provides education and training to clinical staff ensuring optimal documentation and charge capture as well as coding integrity reviews. Serves as the liaison between clinical charge capture, information systems and others within the Revenue Cycle Systems and Charge Systems. Ensures accurate and comprehensive charge capture of services through various tools and mechanisms including education, audits, workques, root cause analysis and others as needed. Serves as Charge Description Master for Montefiore Medical Center, Mount Vernon, and New Rochelle. Manages the work of the Chargemaster Manager of Mount Vernon and New Rochelle. Ensures the coding of the new and existing charge codes and partners with appropriate teams to create charge codes and provide reimbursement analysis and guidelines for billing and prevention of denials.
A degree or certificate in hospital coding (i.e., CCS, CPC-H, RHIT, or RHIA) is required. Epic Charge Certification is preferred.
Minimum Qualifications:
1. Bachelor’s degree in business/finance, accounting or nursing is preferred.
2. A minimum of five to seven years of Hospital Charge Master experience and/or billing or coding experience focused on the CDM.
3. Strong quantitative, analytical, and communication skills required.
4. Detailed knowledge of the CDM, charge capture processes, and operational issues related to the CDM. Demonstrated knowledge of CMS regulations, OIG compliance, third party requirements, and JCAHO standards.
5. Proficiency in payment review systems, hospital information systems, insurance terms and payment and coding methodologies. In depth knowledge of revenue codes, CPT/HCPCS Level II codes, billing and coding edits (i.e., CCI, OCE, and MUE), and billing and reimbursement practices.
6. Understanding of UB-04, itemized statement and medical records in addition to the familiarity with all ancillary department functions for the facility.
7. Previous clinical experience in an acute care facility is preferred.
Department: Revenue Cycle Bargaining Unit: Non Union Campus: TARRYTOWN Employment Status: Regular Full-Time Address: 555 South Broadway, Tarrytown
Shift: Day Scheduled Hours: 8 AM-4:30 PM Req ID: 221006 Salary Range/Pay Rate: $78,750.00 - $105,000.00
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
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