CHARGEMASTER SPECIALIST
Req #: | 170174 |
Department: | |
Job Location: | Other Location |
Job Location Detail: | UW TOWER - 4333 BROOKLYN AVE NE |
Posting Date: | 07/23/2019 |
Closing Info: | Open Until Filled |
Salary: | Commensurate with Education and Experience |
Shift: | First Shift |
Notes: | This position provides opportunities to work in a fast-paced, challenging, diverse and rewarding environment. As an employee you will enjoy generous benefits and work/life programs. For detailed information on Benefits for this position, click here. |
UW MEDICINE owns or operates the following: Harborview Medical Center, Northwest Hospital & Medical Center, Valley Medical Center, UW Medical Center (UWMC), a network of UW MEDICINE Neighborhood Clinics that provide primary care, UW Physicians, UW School of MEDICINE, Airlift Northwest, and other owned, operated, or affiliated entities as appropriate. In addition, UW MEDICINE shares in the ownership and governance of Children’s University Medical Group and Seattle Cancer Care Alliance a partnership among UW MEDICINE, Fred Hutchinson Cancer Research, and Seattle Children’s
The primary responsibility of the CHARGEMASTER SPECIALIST is to ensure a compliant and effective Charge Description Master (CDM) and corresponding fee sheets/eFeesheets and PreferenceLists/SmartTools for UW Medicine clinical service areas. The successful applicant will know and be able to effectively apply pertinent laws and regulations; work with the Chargemaster Operations team to ensure process standardization and quality controls; and proactively perform routine reviews of own work to ensure compliance.
The Chargemaster Specialist must have skills and knowledge that span the UW Medicine revenue cycle. This role is responsible for working with a diverse group of people from all UW Medicine entities to identify revenue cycle improvement opportunities. The position requires a consistently team-focused approach to the work, a thorough understanding of Clinic / Department and Revenue Cycle operational processes, and an understanding of Epic applications and the data / business intelligence tools (ex: BOE) utilized across the UW Medicine enterprise.
As a part of the administrative team responsible for UW Medicine Revenue Cycle processes, charge capture improvement, and UW Medicine Chargemaster Operations and Revenue Integrity initiatives, this position is vital to the financial viability of UW Medicine as a whole.
RESPONSIBILITIES:
• Maintain the integrity and accuracy of the chargemaster: this includes annual review, issue trouble-shootings, and timely response to requests, with focus on UW Medicine departments / clinics.
• Collaborate with clinical areas and Revenue Integrity to implement appropriate responses to meet processing demands and customer requests and improve reimbursement.
• Develop and maintain fee sheets (paper and electronic) as well as Preference Lists/SmartTools for accurate and timely charge capture functions, working closely with service area managers and Revenue Integrity.
• Assist with system analysis related to chargemaster and charge capture functions, (fee sheets, Epic / EpicCare and subsidiary systems).
• Ensure facility and professional charge capture and billing compliance with Federal and State regulations related to the chargemaster.
• Support accurate and timely charge capture through updates to charge capture tools and support workflow changes as needed.
• Define and document recommendations and process changes related to chargemaster operations, charge capture and revenue integrity initiatives, system / weaknesses / errors, software design, and build / test scenarios for system implementations.
• Support internal and external reviews.
• Analyze and develop technical guidance on healthcare finance issues and provide education to service areas as needed for accurate charge capture, billing and coding in collaboration with Revenue Integrity.
• Educate self through industry readings, conferences and other forums on critical healthcare trends including billing and coding and analyze and identify potential implications for UW Medicine Chargemaster Operations and Revenue Integrity.
• Provide other analysis and review of charge capture processes and the chargemaster as required.
REVIEW, EVALUATE, and MONITOR CHARGE CAPTURE / REIMBURSEMENT OPPORTUNITIES
• Work with all required intradepartmental and interdepartmental personnel to identify charge capture / reimbursement issues and to define resolution approach using available mechanisms [EpicCare, Epic PB, Epic HB, ORCA charge utilization reports, Epic BOE etc.] in collaboration with Revenue Integrity.
• Perform analysis and troubleshooting for charge capture / missing charge resolution in collaboration with Revenue Integrity.
• Assist with the documentation of new operational procedures / processes related to charge capture.
CODE UPDATE / FEE SHEET MAINTENANCE
• Review government-provided code updates and translate this information into documentation / plan for making updates to existing code sources (systems, paper/electronic fee sheets).
• Act as quality assurance liaison between UW Medicine Clinics / Departments, EpicCare IT, HIM / Coding, and UW Medicine Compliance.
• Coordinate and communicate updates within UW Medicine Clinics / Departments and the fee sheet vendor. Participate in leading work with user groups to provide diagnostic assistance, resolution to questions, and problem direction.
• Lead and participate in discussions regarding system updates for codes / fee sheets, and provide diagnostic assistance, resolution to questions and problem direction when required.
• Maintain clear and consistent communication with involved parties regarding code set and workflow changes.
COMPLIANT CHARGEMASTER / EAP MAINTENANCE
• Identify, report and rectify Chargemaster / EAP items that are non-compliant from charging / billing perspectives.
• Assist with and document the development of new operational procedures / processes related to Chargemaster operations / Epic EAP Master Files.
EPIC WORKQUEUE ISSUE RESOLUTION
• Research and analyze charges held up in Epic Charge Review "Not in Fee Schedule" WQs for UWMC/HMC/NWH. Submit pricing requests to Chargemaster Analyst when appropriate and request addition to fee schedule(s).
• Provide feedback to applicable UW Medicine Clinics/Departments and Revenue Integrity regarding issues identified and facilitate discussions to further identify root cause(s) and potential resolution(s) where appropriate.
OTHER DUTIES, AS ASSIGNED
• Act as backup for other team members and functions, as needed
• Complete ad-hoc system and/or process analysis / documentation as assigned
• Works independently and in team environments
• Participates in leadership of design and implementation groups
• Provides status reports to leadership as required
REQUIREMENTS:
Bachelor’s degree or equivalent applicable experience AND at least five years’ experience in the healthcare industry.
Extensive experience in with hospital billing or reimbursement.
Understanding of CMS regulations and ability to interpret healthcare guidelines and regulations.
Proven analytical, verbal and written communications skills.
An equivalent combination of education and experience may substitute for stated requirements.
DESIRED:
Experience working in HIM / Coding and / or as a Hospital Clinic manager or supervisor is desired.
Clinic Operations expertise from working in specialty clinics is desired / beneficial for this role, particularly in specialty areas that include Neurology, Neurosurgery, Oncology and/or Psychiatry.
Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.
The University of Washington is a leader in environmental stewardship & sustainability, and committed to becoming climate neutral.
The University of Washington is an equal opportunity, affirmative action employer. To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 / 206-543-6452 (tty) or dso@uw.edu.