Chargemaster Manager

Pay range: $82,971 -$124,467 annually, based on experience and qualifications.

This position comes with a comprehensive benefits package that includes medical, dental, vision, a 403(b) retirement plan, and a generous Earned Time Off (ETO) program.

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE:                                      Manager System Charge Integrity

REPORTS TO POSITION:      Senior Director – System Revenue Integrity

DEPARTMENT:                       Revenue Integrity

DATE LAST REVIEWED:        June 2024

OUR VISION:                           Creating America’s healthiest community, together

OUR MISSION:                       In the spirit of love and compassion, better health, better care, better value

OUR VALUES:                         Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity department focuses on charge capture optimization and documentation improvement through collaboration and education.  The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver delightful, transparent, and seamless experience to our patients and customers that captures and collects the revenue earned by St. Charles Health System (SCHS) in a quality, efficient and timely manner.

POSITION OVERVIEW: Responsible for oversight and management of the daily operations of chargemaster and revenue integrity operations teams. This position should have advance knowledge of managing hospital chargemaster and clinic fee schedules along with advanced knowledge of general coding and NCCI edits. This role will help identify and implement opportunities in the chargemaster to improve charge capture, charge capture methodologies, or improve charge capture processes. Maintains compliance with the Pricing Transparency regulation by leading and managing the work necessary to meet these requirements. This position plays a key role in the health systems charging and overall financial integrity.

This position directly manages revenue integrity caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Maintains daily oversight of CDM functions including charge builds, pricing and implementation for use.

Works with Revenue Cycle, clinical, and other operational leaders across the health system to ensure clinical documentation management supports charge capture of services rendered as per applicable coding, charging, and billing guidelines.

Maintains and revises policies and procedures related to chargemaster and charge capture functions to ensure alignment with regulatory requirements and industry standards.

Provides direction and support to revenue integrity analysts in maintaining workflows, decentralized work queues, and CCI edits owned and managed by revenue integrity.

Provides reports to leadership on key metrics that support departmental and organizational initiatives.

Responsible for responding and coordinating any internal or external chargemaster audit requests.

Develops and manages the annual work plan for chargemaster and revenue integrity analysts.

Leads and manages annual pricing updates for St Charles and connect partners.

Responsible for managing and collaborating with necessary departments on pricing transparency to ensure compliance with regulatory requirements and any applicable changes over time.

Responsible for budget development, regular monitoring, accountability and meeting all operational targets for all areas within span of control.

Hires, directs, coaches and monitors the performance of all direct reports, to develop and maintain a high performance team that meets organizational and department goals.

Monitors and ensures all direct reports are current with compliance and safety requirements. Implements and manages all organizational safety directives and goals.

Provides and oversees team’s delivery of customer service in a manner that promotes goodwill, is timely, efficient, and accurate.

Collaborates with teams to review processes and identify/implement opportunities for improvements, applying Lean principles, concepts and tools.

Supports the vision, mission, and values of the organization in all respects.

Supports the Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

May perform additional duties of similar complexity within the organization, as required or assigned.                    

EDUCATION:                  

Required:   Associates degree or combination of education and experience to perform the full scope of the role.

Preferred:  Bachelors Degree in Healthcare related field.              

LICENSURE/CERTIFICATION/REGISTRATION:

Required: One of the following: RHIT/RHIA, CPMA, CPC, CRCR, CHRI or clinical licensure. Epic certification or ability to obtain within 6 mo. of hire.   

Preferred: Combination of clinical licensure and applicable coding or revenue integrity certification.      

EXPERIENCE:

Required: 3+ years chargemaster experience, 1-year prior leadership experience.

Preferred: 2-4 years chargemaster manager experience within a health system. Epic clinical documentation management experience.             

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Travel: Ability to travel to business functions/trainings/meetings and all SCHS worksites.

Schedule Weekly Hours:

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