Revenue Integrity Chargemaster Analyst II

• Maintains the integrity of the Chargemaster by ensuring adds, changes, reactivates and inactivates are completed within 48 hours of receipt of job request.
• Communicates all adds, changes, reactivates and inactivates to IS so that they can ensure the integrity of the clinical information systems charges.
• Maintains integrity of user access to all components of the Chargemaster system applications.
• Updates user access to the various systems applications.
• Provides education and training and is a resource to clinical staff that has user access to Chargemaster system applications.
• Actively works regulatory exceptions in the Chargemaster system applications. Notates observations as appropriate within system.
• Communicates exceptions issues to appropriate Revenue Integrity personnel and Revenue Management team members as directed by Manager.
• Researches pre-bill audit accounts as assigned and reports findings to members of the Revenue Integrity team and others as Manager directs.
• Reads regulatory alerts within Chargemaster system applications and notifies all appropriate personnel affected.
• Performs all functions necessary to run Chargemaster scripts effectively.
• Cross reference items in the Materials item file and identify opportunities.
• Reports monthly on exception status of Chargemaster system applications.
• Maintains logs, spreadsheets and working files to monitor day to day progress, concerns and changes within the Chargemaster system applications.
• Completes special projects as assigned meeting goals and timeline. Establishes rapport and maintains collaborative relationship with peers.
• Provides mentoring and education to team members within the Revenue Integrity Department.
• Works collaboratively with IS, Nursing and Revenue Management leadership in the process improvement and implementation of charge capture opportunities.
• Actively interacts in a Task Force that meets on a regular basis with members of the revenue cycle.
• Represents the Revenue Integrity department professionally and positively in both formal and informal settings by maintaining a high level of professional demeanor and dress at all times.
• Reports charge capture successes as they occur in charge entering areas.
• Maintain policies, procedures and manuals as appropriate.
• Understands and can apply pricing methodologies to charges.
• Assists as directed in annual review of departments whose charges are grouped by APC, relative weight or any other level assignment to ensure validity of charging practices.
• Maintains the Revenue Integrity Website.
• Reviews regulatory alerts and updates as they pertain to areas of responsibility, makes changes in the Chargemaster system applications and notifies Revenue Integrity Management and Liaisons as appropriate.
• Ensures all system application mapping updates are completed as directed.
• Performs monthly, weekly and daily reconciliation processes timely.
• Reviews financial system exception reports weekly, makes corrections as appropriate and shares opportunities with Revenue Integrity team members.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.

• Maintains compliance with all Orlando Health policies and procedures.

• Mentor and train new team members.

• Bachelor degree in business administration, finance, computer science or healthcare related field.

• Associate degree and two (2) years of directly related work experience may substitute for the Bachelor degree (in addition to the requirements listed in the Experience section).

• Four (4) years of directly related work experience may also substitute for the Bachelor’s degree (in addition to the requirements listed in the Experience section).

• Two (2) years of experience working with revenue cycle.

• Must understand the Revenue Cycle in a hospital.

• Must have knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and other third party billing rules and coverage.

Orlando Health