MANAGER, CHARGEMASTER
Location: New Haven Connecticut
Description: Yale New Haven Health Services is presently looking of MANAGER, CHARGEMASTER right now, this position will be placed in Connecticut. Detailed specification about this position opportunity please give attention to these descriptions. manages the entire Delivery Network's (DN's) Chargemaster (CDM) staff. Responsible for the management of the DN's chargemaster maintenance, update and development and manages associated revenue enhancement projects. Leads multi -disciplinary work groups on projects associated with the chargemaster and revenue enhancement. Manages staff on numerous, simultaneous projects, and coordinates the work of other colleagues on same. Assures chargemaster accuracy and integrity. Communicates with all DN's clinical management and other vice presidents on new updates. Serves as internal resource on chargemaster and coding issues.
RESPONSIBILITIES Oversees the Delivery Network's Chargemaster staff, maintains a project inventory and work plan, including project description, expected outcome, timeframes, achievements to date, expected project valuation, future planning requirements and staffing. Manages all internal and external audits related to but not limited to revenue integrity, the CDM and its components. The Manager of the Chargemaster is the point person for all Revenue Integrity Audits performed by the Office of Privacy & Corporate Compliance. Manages and conducts financial reviews to determine charge capture accuracy and comprehensiveness .Reviews include observance of operational procedures (enhanced business practices), documentation reviews, validation of data entry and final data capture and other aspects of operational audits. Reviews may be conducted with assistance from clinical staff, Internal Audit and Compliance staff. Ensures accurate establishment of clinical charges, descriptions and billing codes in the chargemaster .Ensures accurate cross-walk of chargemaster details with underlying clinical systems used for charge capture and clinical documentation. Ensures compliance with pricing policy. Leads efforts of multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital pricemaster. Leads other multi-disciplinary work groups in revenue enhancement projects including Denial Management and APC Billing committees. Working with groups, also develops new areas of review for future revenue enhancement. Groups may include representatives from various clinical areas, Coding, Medical Records, Billing, Compliance and Information Systems. Calculates the expected net revenue impact of chargemaster project efforts (RCM). Reports RCM numbers to senior leadership in a timely, accurate and concise manner. Provides guidance to and supports clinical departmental needs on questions, process, status and planned changes or updates to the chargemaster. Manages communication of routine changes to coding and billing protocols and conventions to affected clinical departments. Promotes and manages the corporate philosophy of positive customer relations.
REQUIREMENTS:
B.A. or B.S. in Accounting, Finance, or Nursing required. Master's degree in relevant field preferred. Seven years' experience in health care finance, billing, coding, direct clinical care, reimbursement, accounting, budget, compliance or insurance required with progressive responsibility in accountability, leadership, supervision, and project management. Considerable knowledge of medical records, CPT coding, billing and medical terminology is required .Demonstrated ability to lead groups and work on numerous projects simultaneously. Previous management experience is must. Must have the ability to influence and direct the thinking of others and deal with all levels of management and different types of staff. Responsible for the management of revenue enhancement projects related to chargemaster for the DN, which contribute directly to annual revenue performance; work is done in a fashion that is compliant with Medicare and other payors' standards. Assures the success of numerous projects by offering technical knowledge, oversight and coordination to charge capture and revenue enhancement opportunities. Manages and coordinates the assurance of information systems' connectivity and accuracy related to charging and charge capture. Investigates problems and makes recommendations for future projects related to revenue enhancement. Manages the work of the CDM staff. Manages the project workplan for revenue enhancement efforts. Oversees the timely and accurate preparation of all on-going charge analyses and data reports required by outside agencies and regulators, e.g., OHCA, CHA and others. Manages the selection, training and performance evaluation of staff. Serves as the on-site expert on revenue enhancement issues for the Hospital and coordinates efforts with System management and departmental colleagues, who are off-site. Manages and directs multi-disciplinary efforts at revenue enhancement and chargemaster maintenance and development. Exercises independent judgment and discretion in the performance of chargemaster duties. Manages project priorities, staffing assignments and financial valuations of opportunities. Acts as a resource and coordinator for the revenue matters at all the Hospitals, and supports the related information systems functions. Located in New Haven, but will be required to travel and work from all DN hospitals.
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This position starts available on: Fri, 10 Aug 2012 04:35:10 GMT