Charge Capture Manager - Managed Care (Hybrid Remote)

The University of Texas Medical Branch

Galveston (TX)

Hybrid

USD 85,000 - 120,000

Full time

4 days ago

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Benefits offered by this job

Hybrid work arrangement

Hybrid in-office/remote role

Job summary

The University of Texas Medical Branch (UTMB Health) in Galveston, TX seeks a Charge Master manager to oversee charge capture integrity and the CDM. You will collaborate with School of Medicine, Revenue Cycle Operations and Revenue Integrity to maximize gross revenue and drive CDM improvements.

Responsibilities include annual CDM reviews, policy development, CPT/HCPCS assignment accuracy, and leadership of CDM staff in a hybrid work setting.

Qualifications

CDM charging and CPT/HCPCS review knowledge
Ability to interpret regulatory requirements and apply them
Experience with hospital revenue cycle processes

Responsibilities

Conduct annual CDM strategic and operational reviews
Develop and maintain CDM policies for pricing updates
Facilitate charge router logic reviews with Revenue Integrity
Analyze CDM assignments to ensure CPT/HCPCS accuracy
Support management with CDM changes and approvals
Review revenue department charge volumes and posting lag
Distribute coding and billing regulatory requirements
Serve as SME to CDM Analysts and Revenue Integrity
Hire, supervise, train and evaluate staff

Skills

Charging practices

Statistical analysis

Regulatory knowledge

Epic proficiency

Medicare schedules

Communication skills

Time management

Project management

Independent work

Continuous learning

Education

Bachelor’s degree in finance, Business Administration, Health Care Administration, Nursing, or related field

Tools

CCA (Certified Coding Associate)

CCS (Certified Coding Specialist)

CCS-P (Physician-based)

CPC (Certified Professional Coder)

AAPC-COC (Outpatient)

AAPC-CIC (Inpatient)

CPC-P (Payer)

CPT (Certified Pharmacy Technician)

Job description

Bachelor’s degree in finance, Business Administration, Health Care Administration, Nursing, or related field.
Five years’ related experience.in healthcare revenue management.
An equivalent combination of education and experience relevant to the role may be considered for this position.

Education & Experience

Minimum Qualifications

Bachelor’s degree in finance, Business Administration, Health Care Administration, Nursing, or related field.
Five years’ related experience.in healthcare revenue management.
An equivalent combination of education and experience relevant to the role may be considered for this position.

Licenses, Registrations, or Certifications

Certified Coding Associate (CCA), or
Certified Coding Specialist (CCS), or
Certified Coding Specialist - Physician-based (CCS-P) certification from AHIMA; or
Certified Professional Coder (CPC), or
Certified Outpatient Coder (AAPC-COC), or
Certified Inpatient Coder (AAPC-CIC), or
Certified Professional Coder – Payer (CPC-P) certification from AAPC; or
Certified Pharmacy Technician (CPT)

Job Summary

Oversees the integrity of charge capture and the Charge Description Master (CDM) in its entirety. Works closely with the School of Medicine, Health System leaders, Revenue Cycle Operations (RCO), and Revenue Integrity to ensure accurate and timely charging, to recommend process improvements as needed, and to maximize gross revenue.

Essential Job Functions

Conduct annual strategic and operational review of the CDM.
Develop and maintain policies and procedures for CDM maintenance, pricing updates, and charge capture processes.
Facilitate charge router logic review with Revenue Integrity and Coding counterparts to ensure accurate assignment of charges for services performed.
Facilitate analysis of the CDM to ensure accurate assignment of CPT/HCPCS and revenue codes to the Charge Master in order to comply with regulatory practices.
Provide assistance and analysis to all levels of management in support of suggested, requested and/or mandated changes to the CDM.
Assist in reviewing and reporting all revenue departments’ charge volumes, posting lag days, and charge capture performance.
Distribute coding and billing regulatory requirements and/or announcements to all applicable departments.
Serve as a subject matter expert to Charge Master Analysts and the Revenue Integrity department for efforts to maintain the CDM and improve operational workflows.
Hire, supervise, train and evaluate employee performance.

Marginal or Periodic Functions

Adheres to internal controls and reporting structure.
Performs related duties as required.

Knowledge/Skills/Abilities

Excellent understanding of multiple clinical disciplines and charging practices.
Excellent ability to understand and interpret statistical reports and perform quantitative analysis.
Knowledge of state and federal regulations as they pertain to billing processes and procedures.
Knowledge of the principles of Information Systems in order to effectively analyze and make decisions, preferably with proficiency in Epic.
Basic knowledge and understanding of Medicare RBRVS fee schedule, Medicare Hospital APC/OPPS fee schedules, and hospital UB revenue codes.
Skill in effective oral, written, and interpersonal communication.
Skill in problem solving in a variety of settings and translation of data into actionable steps.
Skill in time management and project management.
Ability to work efficiently under pressure.
Ability to work independently and take initiative.
Ability to demonstrate a commitment to continuous learning and to operationalize that learning.
Ability to deal effectively with constant changes and be a change agent.
Ability to deal effectively with challenging situations
Ability to accept responsibility and/or delegate responsibility.
Ability to set priorities and use good judgment for self and staff.

Decision-Making Responsibility

This role is responsible for providing day-to-day guidance to Charge Master Analysts and Revenue Integrity staff as a subject matter expert, and also overseeing day-to-day CDM maintenance actions, pricing updates, and charge capture processes within established policy. Assigns CPT/HCPCS and revenue codes on the CDM to ensure regulatory compliance, and reviews charge router logic corrections identified through review with Revenue Integrity and Coding departments.

Working Environment/Equipment

Hybrid (in-office/remote) role as determined by leadership, utilizing standard office equipment.

Salary Range

Actual salary commensurate with experience.

Work Schedule

Hybrid (in-office/remote) role as determined by leadership, Monday through Friday, 8 am to 5 pm.

Equal Employment Opportunity

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.

Primary Location

United States-Texas-Galveston

Work Locations

0914 - Webster(Clear Lake Ctr)

Job

Business, Managerial & FinanceRegular

Shift

Standard

Employee Status

Manager

Job Level

Day Shift