Duke University Health System (DUHS) Job Descriptions
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CHARGEMASTER ANALYST
Job Title: CHARGEMASTER ANALYST
Job Code: 5500
FLSA: E
Job Level: F2
Revised Date: 11/01/2007
Supervisory Responsibility: No
General Description of the Job Class
Responsible for the oversight of Charge Description Master, Billing, and Reimbursement analysis within the Revenue Management Department. Serve as a member of the Revenue Management team and subscribe to the vision, values and expectations of the Duke University Health System.
Duties and Responsibilities of this Level
Responsible for the oversight of Charge Description Master functions and reimbursement analysis within the Revenue Management Department of the PRMO.
Responsible for the supervision and coordination of Chargemaster and Charge Capture process in researching coding and billing guidelines, researching insurance contracts, and updating hospital and professional Chargemaster and Charge Capture processes. Represents Duke with external vendors (e.g. EPIC).
Works with the revenue producing departments to ensure the ongoing coordinated and consistency with the Chargemaster and Charge Capture processes, including accurate descriptions, coding, additions, deletions, pricing, revenue code and any other changes.
Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines.
Work with Finance, Revenue Recognition and Performance Services Departments to perform applicable analyses to understand budget, net revenue change and labor impact of proposed Chargemaster changes.
Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs and overall expense reduction.
Disseminate CMS updates to health care providers as they relate to billing for drugs, implantable and/or other pass-through eligible items, ensuring the necessary changes are made to the entity specific Chargemaster and Charge capture updates within the time frame for accurate and compliant billing.
Recommend policies and procedures which impacts charge capture and pricing practices.
Responsible for revenue code and coding assignment for all new items or services throughout DUHS.
Oversees the overall maintenance and use of the charge master tool utilized by the Revenue Management Department
Advises and collaborates with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel and outside consultants to analyze, review and assess identified billing, coding, charging and compliance issues.
Perform other related duties incidental to the work described herein.
Required Qualifications at this Level
Education
Bachelor's degree in business, healthcare administration or a related field is required.
Experience
Four years of related experience required.
Degrees, Licensure, and/or Certification
Coding certification is strongly preferred
Knowledge, Skills, and Abilities
Proficient in the use of Microsoft Office Programs, including but not limited to: Excel, Word, Powerpoint, and Access.
Knowledge of Siemens Invision, IDX and/or Meditech preferred.
Extensive knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations and APCs.
Must have a good understanding of the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget.
Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
Ability to research complex coding and regulatory requirements.
Strong analytical skills.
Distinguishing Characteristics of this Level
The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
