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Providence Health & Services Analyst Revenue Integrity - Chargemaster Coordinator in Torrance, California

Description:

Providence is calling a Analyst Revenue Integrity - Chargemaster Coordinator (Full time/Day shift) to Providence California Regional Services in LOCATION, CA.

We are seeking a Analyst Revenue Integrity - Chargemaster Coordinator who will be responsible for charge integrity, charge reconciliation and analysis of financial data as it relates to regulatory compliant charging and billing guidelines. The Revenue Integrity Analysis is responsible for training clinical sites on all aspects of charge accuracy, ensuring maintaining regional and system standards are maintained. This position supports the entire revenue cycle by using clinical expertise and analytical skills to resolve charging and billing issues.

The Regional PB Chargemaster Coordinator is responsible for ensuring the PB chargemaster is complete and accurate, and adheres to all regional and system standards. Is responsible for coordinating additions, changes, and terming of charges for all Providence Southern California PB sites. Coordinates the review of the chargemaster and the implementation of regulatory changes.

Responsible for reviewing, auditing, and improving revenue integrity processes.

In this position you will:

  • Revenue Integrity:

  • Responsible for managing daily revenue as related to charging:

  • Ensure charges post daily

  • Daily Work queue monitoring and analysis of issues

  • Complete knowledge of physician office/clinic daily revenue and clinical application charging sources

  • Serve as a primary revenue integrity resource and liaison for charge producing office/clinics, the CBO, HIM-Coding, and Admitting

  • Work closely with charge producing offices/clinics and PB Epic team to resolve any charging issues

  • Charge Master Operations:

  • Ensure Providence California PB Chargemasters are in compliance with regulatory guidelines

  • Ensure system chargemaster standards are always adhered to

  • Coordinate all additions, deletions and changes made, ensuring CPT and HCPCS are accurately assigned

  • Ensure annual and quarterly chargemaster updates are implemented

  • Responsible for ensuring Chargemaster changes are documented

  • Manage all charge requests changes through the ITSM system and to provide an audit trail for all change requests

  • Ensure finance has the opportunity to address pricing and statistical fields for all chargemaster changes

  • Coordinate chargemaster changes with the CBO to ensure claim forms, prorations and reimbursement schedules are maintained

  • Advise and educate ancillary departments on proper charge and code assignments and the correct use of charges

  • Manage patient, department and administrative requests for a variety of issues related to revenue and charge integrity

  • Educate clinical departments on documentation, charge accuracy and charge compliance

  • Responsible for making recommendations and decisions to ensure billing compliance regulations are adhered to as it relates to charging and billing

  • Maintain expertise in multiple data sources to extrapolate information needed for analyzing and auditing clinical and financial records. Limited to: EPIC

  • Assist in compliance recommended audits, internal audit, and external audits

  • Participate in government requested audits (RAC, OIG)

Qualifications:

Required qualifications for this position include:

  • 5 years revenue integrity experience or related healthcare experience

  • Extensive knowledge of CPT and HCPCs coding requirements, including Medicare and Medi-Cal regulations, NCCI edits, MUE, LCDs and NCDs

  • Extensive knowledge of chargemaster and charge integrity programs and operations

  • Strong computer skills including working knowledge of EXCEL and WORD. Ability to use Internet search capabilities, online reference sites. Ability to adapt quickly to new systems and tools

  • Familiarity with hospital, SNF, Hospice, Homecare, and free standing imaging charging and billing requirements

  • Knowledge in regards to payer contract requirements, claim logic and proration protocol

  • Excellent communication skills sufficient to allow effective, positive communications with all levels of personnel within the organization, as well as administration, physicians, patients, and their families

  • Strong analytical and problem solving skills

  • Extreme attention to detail, with highly developed organizational and follow up skills

  • Must be able to act independently, with only general supervision, and juggle a number of competing priorities at any given time

  • Requires the ability to establish and maintain cordial, cooperative working relationships with personnel throughout the organization

Preferred qualifications for this position include:

  • Bachelor's Degree in the healthcare or finance field

About the Region you will serve.

For nearly 70 years, Providence Health & Services, Southern California, has provided quality and compassionate health care, building on a tradition of excellence, innovation, teamwork and outreach to those most in need.

Anchored by five award-winning comprehensive medical centers, Providence provides a full spectrum of care that includes a range of specialties, signature services, outpatient and home care and the well-regarded Providence Medical Institute, a group of physicians and primary and urgent care clinics throughout the greater San Fernando Valley and South Bay. Providence is focused on providing the communities it serves with preventive care, education and leading-edge diagnostics and treatment. The organization includes numerous outreach programs. hospice and home care and even our own Providence High School, a Blue Ribbon college-preparatory campus.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Financial Analyst

Location: California-Torrance

Req ID: 257338

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