Staff Analyst - Charge Description Master Analyst (Personal Services)

Salary Range $6,806.73- $9,820.80 /Month

SUMMARY

We are seeking to hire Charge Description Master Analyst responsible for the maintenance of the Enterprise Charge Description Master (CDM). The selected candidate will be responsible for performing administrative and technical CDM maintenance duties and ensure that hospital and clinic charges are captured accurately, promptly, and in compliance with Federal, State, and local health care regulatory agencies. This position requires a dedicated individual who can manage a variety of responsibilities, demonstrate strong problem-solving abilities, and work effectively within a collaborative environment.

ESSENTIAL FUNCTIONS

• Ensure effective capture and reporting of charges in both the Oracle Cerner Millennium Electronic Health Record (EHR) and QuadraMed Affinity RCO systems.
• Work closely with various clinical departments within DHS' EHR Solution, such as Radiology, Laboratory, Oncology, Physical Therapy, Occupational Therapy, Cardiology, and others, to ensure that CDM workflows, documentation, and charge capture systems are accurate and consistently updated. 
• Perform research and analysis on charge data capture that results in denials such as deleted and/or modified CPT/HCPCS codes.
• Assist with resolving and implementing EHR and Affinity RCO errors in workflows, designs, and other revenue cycle system problem.
• Support Charge Master maintenance and updates process, financial/operations impact analysis and review including CPT, HCPCS code, Revenue Codes, Relative Unit Values, Resource Based Relative Value Scale, National Drug Codes, etc. assignment, for the EHR and Patient Accounting.
• Conduct quarterly, annual, or as-needed reviews to ensure that the Charge Description Masters (EHR and Affinity RCO) are updated for new and revised CPT4/HCPCS codes. 
• Process supplies for charge capture in EHR and billing system (Affinity RCO).
• Assist staff with creating Data Collection Workbooks (DCWs) for charge configuration builds.
• Participate with testing of both the EHR and Affinity RCO charging functionality. 
• Validate testing procedures to ensure that new workflows generate charges properly. This includes knowledge of supplies and vendors, as well as, assigning HCPCS to implants and other surgical items.
• Participate in audits to verify compliance with standardized procedures and other code assignment in the EHR, Patient Accounting systems, etc. for adherence to changes/updates required by CMS, other regulatory agencies, and DHS policies.
• Comply with the Charge Master Department's policy and procedures related to charge codes and descriptions.
• Effectively coordinate and facilitate user interaction with Clinical and Enterprise Clinical Services (ECS) teams to define and validate processes that assure effective and efficient charge flows.
• Maintain files that contain the audit trail of Charge Description Master additions, updates, and other changes.
• Performs special assignments and projects, as directed.
• Complete training related to human resource requirements.
• Participate in meetings.
• Responding to general inquiries.

JOB QUALIFICATIONS

• Minimum three (3) years in a charge description master or revenue integrity related work, broad based knowledge of hospital financial operations including reimbursement.
• Must have knowledge of medical terminology to a wide range of therapeutic and diagnostic situations.
• Must have Knowledge and understanding of CPT/HCPCS, revenue coding, and ICD-10 required.
• Must have knowledge and understanding of Medicare billing regulations, revenue code application, CPT/HCPCS coding and ICD-10 regulations and guidelines. 
• Must possess in-depth knowledge and understanding of hospital and medical foundation services, regulatory requirements, CDM management and project management.
• Must have in-depth knowledge, experience and be proficient with the Oracle Charge Services, Affinity RCO Chargemaster functions and tools, as well as, analyzing charge data a plus.
• Must have knowledge, experience with working with medical supplies for charge capture.  This includes being proficient in reviewing, analyzing medical supplies for assignment of CPT/HCPCS codes in the Charge Masters, and charge capture via Charge Masters.
• Must have knowledge and experience in working with pharmaceuticals, drug formulary, regulatory programs, (e.g. 340B program) CPT/HCPCS code assignments, assigning charge capture drug modifiers.
• Must be proficient in MS Office (Excel, Word, PowerPoint, Access).

Education/Experience 

• Bachelor's degree or higher in Finance, health science, business, information technology, accounting, or related field a plus.
• Experience with medical billing and coding.
• Experience in Craneware tools or similar software system.
• Knowledge of healthcare coding and billing regulations,
• General knowledge and understanding of EHR clinical workflows.
• Must be able to work independently or in a team.

Certificates/Licenses (Preferred/Not Required)

• Certified Revenue Cycle Representative (CRCR) - HFMA
• Certified Revenue Cycle Specialist (CRCS) - AAPC
• Certified Coding Specialist (CCS) - AHIMA
• Certified Charge Capture Professional (CCCP) – AAPC/HFMA

Clearances

• Successful clearing through the Live Scan and the Health Clearance process with the County of Los Angeles.

Other Skills, Knowledge, and Abilities

• Working knowledge of Microsoft Office Programs (Excel, Word, Access, PowerPoint).
• Experience in working with large database, particularly extracting, and manipulating specific files.
• Demonstrates good analytical skills.
• Must apply knowledge of medical terminology to a wide range of therapeutic and diagnostic situations. 

PHYSICAL DEMANDS

Stand: Occasionally

Walk: Occasionally

Sit: Frequently

Handling: Occasionally

Reach Outward: Occasionally

Reach Above Shoulder: Occasionally

Climb, Crawl, Kneel, Bend: Occasionally

Lift / Carry: Occasionally - Up to 15 lbs.

Push/Pull: Occasionally - Up to 15 lbs.

See: Constantly

Taste/ Smell: Not Applicable

 

Not Applicable = Not required for essential functions

Occasionally = (0 - 2 hrs./day)

Frequently = (2 - 5 hrs./day)

Constantly = (5+ hrs./day)

WORK ENVIRONMENT

This position is based in Alhambra, CA with hybrid work schedule (2 days/week). Negotiable.

EEOC STATEMENT

It is the policy of Heluna Health to provide equal employment opportunities to all employees and applicants, without regard to age (40 and over), national origin or ancestry, race, color, religion, sex, gender, sexual orientation, pregnancy or perceived pregnancy, reproductive health decision making, physical or mental disability, medical condition (including cancer or a record or history of cancer), AIDS or HIV, genetic information or characteristics, veteran status or military service.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

See job description