Kaiser Permanente Chargemaster Analyst in Honolulu, Hawaii
Supports and assists the Revenue Cycle in the development, analysis and implementation of any and all charge capture efforts. Audit, review, and provide input to processes and workflows related to timely and accurate charge capture within the framework of the electronic medical record platform. Serve as a resource for compliant CDM implementation and management. Work with clinical and business system development and maintenance. Work collaboratively with all departments to assist in compliant and appropriate business practices. Perform Charge Capture reviews, audits and research.
Researches and analyzes reimbursement practices, compiles data in an organized format and makes recommendations on charge capture changes. Research and monitor codes on services, procedures, supplies, injections, medications and modifiers. Exhibits and maintains an understanding and application of CPT, HCPCS and CMS regulations and guidelines. Assists with implementation of new charges and meets with departments as needed. Provides consultation and education to leadership, department managers and facility staff regarding CDM compliance and related financial issues. Proposes action plan for resolution of issues related to charge capture/CDM. Audits reconciliation reports and identifies services being performed but not charged for or charged inappropriately. Reviews and discusses audit findings with key people needed to address issue.
Provide feedback and representation for CDM and charge capture process. Work with National and Regional consultants as pertains to CDM and charge capture efforts. Provides reports and guidance to leadership to reconcile charge capture efforts. Review and audit revenue processes and charge capture effectiveness to facilitate optimal performance and efficiencies. Assists with data analysis and research for any and all charge capture efforts.
Assists Patient Business Services, Occupational Health, Customer Service, Member Services and Member Relations in responding to coding, billing, and Fee Schedule issues as it relates to compliant charge capture.
- Minimum five (5) years of experience related to CDM or Revenue Cycle.
- Bachelor's degree in coding, billing and/or fee schedule in a health care setting OR four (4) years of experience in a directly related field.
License, Certification, Registration
Experience in the use of CPT, HCPCS, and Revenue codes.
Knowledge of medical terminology, coding rules, state and federal compliance rules and regulations.
Strong research skills.
Ability to compose reports and recommendations.
Strong interpersonal and communications skills.
Detail oriented, problem solving, listening and resolution skills.
Strong time management skills, ability to meet deadlines, and flexibility to complete ad-hoc or urgent projects.
Working knowledge of Microsoft Word, Excel, and Access.
Flexibility to complete immediate projects as needed.
Ability to interpret other applications such as Clarity and HC applications.
Working knowledge of multiple computer systems including EPIC.
Working knowledge of CPT, HCPCS codes, CMS guidelines.
Demonstrate knowledge of and skill in adaptability, change management, conflict resolution, creativity/innovation, decision making, group presentations, group process facilitation, influence, interpersonal relations, oral communication, problem solving, analytical/detailed orientation, results orientation, systems thinking, team building, teamwork, written communication, organizational skills, time management, initiative and prioritization.
CPC, RHIT or Epic Resolute certification.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
TITLE: Chargemaster Analyst
LOCATION: Honolulu, Hawaii
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.