Charge Master Coordinator Job Listing at Lexington Medical Center in West Columbia, SC (Job ID 1207167000)

Description

Revenue Integrity  
Full Time
Day Shift 
8am-5pm

Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina.

The 607-bed teaching hospital anchors a health care network that includes six community medical centers and employs more than 8,700 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina's first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and education. The network also features an occupational health center, the largest skilled nursing facility in the Carolinas, an Alzheimer's care center and nearly 80 physician practices.  Its postgraduate medical education programs include family medicine and transitional year.

Oversees the maintenance and accuracy of the charge description master (CDM) and all related facility fee schedules (FS) to facilitate administrative simplification, billing and coding accuracy, and revenue capture. Monitor all activities that result in data input/revision/deletion into the CDM and related facility fee schedules (FS). Ensures that CDM is accurate and in compliance with all state and federal regulations for billing, coding, and charging methodology. CDM responsibility may include professional and technical components as well as all services rendered including supplies for the service rendered and care provided to the patient.

Minimum Education: High School Diploma or Equivalent
Minimum Years of Experience: 5 Years of experience in a hospital business office or other related area
Substitutable Education & Experience: None.
Required Certifications/Licensure: None.
Required Training: Previous management of or close involvement with the Charge Description Master or other system wide charging repository;
Thorough understanding of billing compliance with governmental programs (Medicare, Medicaid and Tricare) specifically the assignment of revenue codes, CPT-4/HCPCS codes, and modifiers;
Must have strong financial skills with the ability to interpret Federal and State regulations and understand how they apply to our various business lines;
Experience with Windows, Excel, Word and Power Point;
Spreadsheet knowledge.

• Ensures all CDMs are updated routinely and kept current according to regulatory guidelines:  
  • Assist with outsourced CDM reviews including securing possible vendors as well as   setting agenda for on-site review with appropriate department directors.    
  • Coordinates and oversees any external CDM review applications used for routine maintenance of codes or pricing.          
  • Create and maintain work flows and processes to ensure appropriate governmental   changes (Quarterly and Annual updates, additions, deletions) are processed timely and   accurately.
• Analyze, interpret and coordinate appropriate changes according to Healthcare government billing regulations, transmittals and intermediary bulletins for Medicare, Medicaid and Tricare in a timely manner.
• Provide education, training, assistance and expertise on all upcoming or pending regulatory changes to all appropriate personnel. Assists departmental directors/staff implement all indicated changes including:  providing additional education, updating encounter/charge forms or sheets and ensuring implementation timelines are met.
• Position is responsible for maintaining clearly defined, categorized and comprehensive documentation of all items affecting the charge master. This documentation may be used as reference/research for auditors, payers and LMC staff support as required.
• Supervises the dissemination of pertinent information to appropriate departments, entities, and individual positions for implementing the changes.
• Will assist in reviewing new services and equipment and recommending appropriate code assignments and prices (i.e. revenue/CPT/HCPCS, modifiers).
• Monitors and reviews proposed legislation, rule changes, additions and deletions. Provides feedback during ‘comment periods' prior to proposed legislation becoming effective.
• Maintain up to date knowledge of DHHS, CMS (OIG), and DOJ (FBI & US Attorney General) audit and compliance related issues and how they apply to our health system.

• Understand, educate and apply current knowledge of CPT-4, HCPCS, UB-04, 1500 and coverage guidelines when applicable.
• Coordinate with Corporate Compliance, Internal Audit and Medical Records departments if upcoming or pending regulatory changes may need special attention and review for possible compliance.
• Responsible for understanding the CDM function in hospital billing system, as well as how inter-related functions affect and/or drive the charge master. Knowledge should include understanding of all billing and charging tables, as well as the linking of performables and orderables to the EAP.
• Monitor late charge reports by department and recommend revisions to operational charging processes in order to minimize late charges when appropriate.
• Position co-chairs the hospital wide Charge Master Committee. Ensures that all recommended additions/revisions/in-activations are researched and when appropriate forwarded to change control for input into the hospital billing system in a timely and accurate manner.
• Assists in fee schedule analysis and rate setting for multiple hospital billing system Fee Schedules.  Update the hospital billing system fee schedules annually upon completion of the budget process and determination of upcoming rates by senior management.
• Actively work pools and work queues within the hospital billing system and the hospital claims clearinghouse (router review, router error pool, claim edits, charge review and account reviews) to resolve errors which impede charging and or claims, which may adversely affect cash flows.
• Performs all other job-related duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our employees and their families:

• Day ONE medical, dental and life insurance benefits 
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one.  LHI matches dollar for dollar up to 6%.
• Employer paid life insurance – equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary 
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer
It is the policy of LMC to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. LMC strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. LMC endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.