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

Description:

Apply today! Applicants that meet qualifications will receive a text with additional questions from our MODERN HIRE screening and interview system.

Providence is calling an Analyst Revenue Integrity Chargemaster (Full time/Day shift) at our Providence Medical Institute in Torrance, CA.

The schedule for this position is Mon-Fri with the need for flexibility to start at 7:30am, 8am or 8:30am.

Please upload a current resume reflecting all relevant experience.

We are seeking a Analyst Revenue Integrity Chargemaster who will be responsible for charge integrity, charge reconciliation and analysis of financial data as it relates to regulatory compliant charging and billing guidelines. 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.

Responsible for ensuring the Professional Billing 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

  • 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)

  • Participate in new clinic acquisitions and DOWs (department out of waves)

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

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 fields

About the location you will serve:

Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective. ​​​​

For information on our comprehensive range of benefits, visit:

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 is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. 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: 289894

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