Senior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)

Job Description

Job Description

At Northbay Health, the Senior System Specialist, Chargemaster, is instrumental in ensuring a compliant and accurate Chargemaster across the organization. This role serves as an expert and liaison between Finance, clinical departments, and hospital-based clinics on all CDM matters. The Senior System Specialist actively supports compliance by overseeing system data revisions, participating in high-priority CDM projects and meetings, and assisting in the development and delivery of training sessions for system staff. This position directly contributes to optimizing the revenue cycle and maintaining regulatory compliance.

Primary Job Duties

• Manages the long-term integrity of the Chargemaster, including pricing for CPT and HCPCS codes.
• Manages all updates and modifications to the CDM.
• Assists with Chargemaster configurations across all relevant software applications.
• Collaborates with hospital departments and Information Technology to develop a strategic roadmap for an optimized and compliant Chargemaster across all integrated systems.
• Develops and implements comprehensive policies, procedures, tools, and forms to support efficient Chargemaster maintenance.
• Assists with the implementation of policies, procedures, tools, and forms to support efficient Chargemaster maintenance.
• Assists departments with Chargemaster compliance, including auditing and quality assurance activities.
• Participates in cross-functional meetings with key stakeholders, including Patient Financial Services, Information Systems, Health Information Management, and clinical departments to proactively analyze error reports, audit findings, and regulatory updates.
• Follows up on outstanding issues and tasks, facilitating meetings with relevant hospital departments and administrative representatives to implement necessary corrections.
• Escalates issues to the Manager, Revenue Integrity, as appropriate.
• Assists with ongoing billing compliance by reviewing billing manuals and regulatory requirements with staff and departments as needed.
• Leads the preparation, education, implementation, and ongoing monitoring of changes to APCs, DRGs, and payer fee schedules.
• Researches complex reimbursement issues and collaborates directly with department directors to ensure seamless adaptation and compliance.
• Assists with Chargemaster compliance initiatives, including investigatory activities and findings related to Chargemaster billing data.
• Assists with the maintenance of CDM software applications.
• Collaborates with Information Technology and relevant departments to optimize the efficiency and functionality of charge service activity interfaces.
• Assists with training users on batch charge entry procedures.
• Provides regular updates to the Revenue Integrity Manager.
• Enhances professional growth and development through educational programs, seminars, and other learning opportunities.
• Performs regular department audits to maximize and ensure the accuracy of charge capture.