Charge Master Analyst - Revenue Integrity - FT Days

UCI group; Irvine (CA); Hybrid; USD 120,000 - 160,000; Full time

Job summary

UCI Health in California seeks an experienced Chargemaster Manager to lead the comprehensive management of inpatient and outpatient charges, including Room & Board, Pharmacy, DME and ancillary services. You will drive charge capture development and rate analysis to align hospital charges with physician charges.

The role requires at least 3 years in CDM management within a large healthcare system, CPC certification, and strong regulatory knowledge.

Qualifications

• 3 years experience with CDM management.
• 3 years experience in an academic or large healthcare system.
• 3 years experience as a Certified Professional Coder (CPC).
• Knowledge of Medicare, Medicaid and other payers.
• Excellent written and verbal communication in English.

Responsibilities

• Manage the Charge Description Master for inpatient and outpatient charges (Room & Board, Pharmacy, DME, SOS 22 ambulatory care, ancillary services).
• Develop charge capture and perform rate analysis to align hospital and physician charges.
• Serve as primary liaison for institutional charge application and regulatory charge guidelines.
• Collaborate with Clinical Care Partners, Revenue Cycle Associates and IT Business Analysts to make Chargemaster decisions.

Skills

CDM management

CPC certification

Healthcare coding

Customer service

Regulatory understanding

Microsoft Office

Tools

Epic PB Resolute

Job description

Who We Are

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.

As Orange County's only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region's only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary

The incumbent is responsible for the management of the Charge Description Master for all inpatient and outpatient technical charges including Room & Board Care, Pharmacy, Durable Medical Equipment, SOS 22 ambulatory care practices and ancillary services. Additional functions include charge capture development, rate analysis and appropriate alignment of hospital charges to physician charges. Incumbent is the primary liaison in providing expertise for all institutional charge application and regulatory charge guidelines for the hospital. Works independently and collaboratively, as needed, with Clinical Care Partners, Revenue Cycle Associates and IT Business Analysts to make decision regarding the Chargemaster.

What It Takes to be Successful

Required Qualifications

• Skill to effectively work with all levels of health system personnel including directors and physicians
• Skill in ad hoc technical report writing, complex analyses and data conversion into different formats
• Skill converting master files in to reports for departmental use
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must have a clear understanding of third-party regulatory requirements including Medicare, Medicaid, Managed Care and Commercial.
• Must demonstrate customer service skills appropriate to the job
• Knowledge of the healthcare industry with an in-depth knowledge of coding, billing and revenue management policies
• Knowledge of split claim billing
• Knowledge of healthcare revenue cycle function spanning across different areas as well as cost accounting and of payer reimbursement as it relates to charges
• Knowledge of coding software tools to maintain current charging and billing guidelines
• Excellent written and verbal communication skills in English
• Demonstrated advanced computer knowledge and experience with Microsoft Office
• Ability to maintain a work pace appropriate to the workload
• Ability to establish and maintain effective working relationships across the Health System
• Ability to analyze situations, define problems, research and formulate conclusions and make sound recommendations
• 3 years experience with CDM management
• 3 years experience in an academic or large healthcare system
• 3 years experience as a Certified Professional Coder (CPC)
• 3 years chargemaster management experience

Preferred Qualifications

• Skill to read and correctly interpret governmental and commercial payor regulations and develop and implement recommendations consistent with interpretations
• Knowledge of University and medical center organizations, policies, procedures and forms
• Epic PB Resolute certification

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

Exercise the utmost discretion in managing sensitive information learned in the course of performing their duties. Sensitive information includes but is not limited to employee and student records, health and patient records, financial data, strategic plans, proprietary information, and any other sensitive or non-public information learned during the course and scope of employment. Understands that sensitive information should be shared on a limited basis and actively takes steps to limit access to sensitive information to individuals who have legitimate business need to know. Ensure that sensitive information is properly safeguarded. Follow all organizational policies and laws on data protection and privacy. This includes secure handling of physical and digital records and proper usage of IT systems to prevent data leaks. The unauthorized or improper disclosure of confidential work-related information obtained from any source on any work-related matter is a violation of these expectations.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization