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Is the subject matter expert for the chargemaster for all WVUHS entities. Role requires behind-the-scenes expertise on data structure and business processes. Pursues internal and external professional development activities, such as: attending conferences, seminars, etc. Uses performance improvement, project management, cost accounting, and/or technological skills to work with all levels of WVUHS leadership and medical staff.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s degree in Accounting, Finance, Business Management, Business Administration, Hospital Administration or related field AND Two (2) years’ experience in Chargemaster set-up, coding, or patient financial services OR;
High School Diploma or equivalent AND Six (6) years’ experience in Chargemaster set-up, coding, or patient financial services.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s degree in Accounting, Finance, Business Management, Business Administration, Hospital Administration or related field
EXPERIENCE:
1. Five (5) years’ experience in Chargemaster set-up, coding, or patient financial services.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Ensures all charging information including pricing, HCPCS codes and descriptions, revenue codes, CPT codes are current and compliant.
2. Assists in ensuring that the chargemaster is in accordance with government compliance policies and procedures, as well as third party payor needs.
3. Works with revenue producing departments to ensure the ongoing coordination and consistency with the chargemaster and charge capture process, including accurate descriptions, coding, additions, deletions, pricing and revenue code changes.
5. Responsible for revenue code and coding assignments for all new items or services throughout WVUHS.
6. Advises and collaborates with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel and outside consultants to analyze, review and assess billing, coding, charging and compliance issues.
7. Serves as subject matter expert (SME) for data analytics, EPIC and hospital chargemaster.
8. Conducts complex data analysis, queries, programs and automation.
9. Uses analytical methods to ensure reported data is meaningful and accurate.
10. Demonstrates technical expertise in data analytics using various systems and tools such as Microsoft Office Suite.
11. Provides analytical insights from data to drive revenue/reimbursement decisions
12. Self-directs workload and balances quality of work with deadlines to fulfill user expectations and project goals
13. Manages expectations and engages management to review/resolve any potential changes to project scope, expected deliverables, etc.
14. Implements changes while adhering to the change control policy and procedures for the project in order to deliver a successful solution to the customer.
15. Participates in training and professional development sessions.
16. Offers assistance and support to co-workers.
17. Balances team and individual responsibilities.
18. Works proactively and cooperatively in group problem-solving situations.
19. Proactively works to resolve conflicts.
20. Engages peers/employees in improving the quality of the work.
SKILLS AND ABILITIES:
1. Ability to handle and maintain confidential information
2. Ability to work well under high stress conditions
3. Ability to work independently or cooperatively as a team member
4. Ability to adapt to various workloads and assignments
5. Ability to work with multi-disciplinary groups and facilitate meetings
6. Must have reading and comprehension ability
7. Must be able to type
8. Must be able to read and write legibly in English
9. Possess good oral and written communication skills
10. Ability to prioritize tasks
11. Must have independent decision-making ability
12. Ability to work in a fast paced and rapidly changing environment
13. Must be flexible
Additional Job Description:
Scheduled Weekly Hours:
40
Shift:
Exempt/Non-Exempt:
United States of America (Exempt)
Company:
SYSTEM West Virginia University Health System
Cost Center:
660 SYSTEM Revenue Integrity
