Charge Master Specialist, Observation Charge Audit

Sutter Health; Oregon; Hybride; USD 117 000 - 176 000; Plein temps

Avantages offerts par ce poste

Comprehensive benefits package

Résumé du poste

Sutter Health is seeking a charge capture expert to partner with clinical service leaders across Interventional Radiology, Operating Room, and Observation to standardize and optimize charge capture practices.

You will reconcile charges, research payer requirements, and drive revenue-management initiatives to ensure compliant, accurate coding and optimal reimbursement across service lines.

Qualifications

• Bachelor's degree in Health Information or related field, or equivalent experience.
• 5 years recent relevant experience in charge capture and medical billing.
• RN/RHIT/RHIA/CPC/COC certifications are preferred or listed as acceptable credentials.

Responsabilités

• Serve as charge capture expert to clinical service line leaders for complex areas (IR, OR, Observation).
• Champion standardization of charge capture processes across service lines.
• Perform charge reconciliation and identify improvement opportunities.
• Research payer requirements and ensure reimbursement practices align with regulations.
• Monitor service-line revenue management and communicate findings to leaders.

Connaissances

Medical billing terminology

CDM/Charge Capture

Payer requirements knowledge

Regulatory publications awareness

Process design and improvement

Financial analysis

Communication skills

Time management

Team collaboration

Formation

Bachelor's in Health Information or related field

Outils

EPIC

Description du poste

We are so glad you are interested in joining Sutter Health!

Organization

SHSO-Sutter Health System Office-Valley

Position Overview

Serves as charge capture/charge description master expert to clinical service line leaders for complex procedure areas such as Interventional Radiology, Operating Room, or Observation across Sutter Health. Focuses on specific clinical service lines to ensure best practices. Champions standardization of charge capture process, and ensures appropriate discipline-specific charge capture as it relates to government and commercial payer requirements. Performs charge reconciliation activities, industry best practice research, and identifies and deploys charge capture improvement initiatives. Ensures charge capture revenue management opportunities are identified and service line specific reimbursement and revenue management is reviewed and monitored.

Education

Equivalent experience will be accepted in lieu of the required degree or diploma. Bachelor's in Health Information or Science such as Nursing, Imaging, Clinical Laboratory or related field.

Certification & Licensure

• RN-Registered Nurse of California
• RHIT-Registered Health Information Technician
• RHIA Registered Health Information Administrator
• CPC-Certified Professional Coder
• COC- Certified Outpatient Coder
• None

Typical Experience

5 years recent relevant experience.

Skills and Knowledge

• In-depth knowledge of medical and billing terminology, common procedure terminology, healthcare common procedure coding system, and revenue codes.
• Knowledge of government and/or commercial payer requirements.
• Knowledge of Federal, State, and Local regulatory publications and how to access.
• Knowledge/ awareness of all areas related to CDM/Charge Capture management functions in acute and non-acute settings and how they interrelate.
• Knowledge of principles, methods, and techniques related to healthcare billing/collections.
• Ability to develop and deliver specific service line education materials.
• Ability to execute strategy and communicate knowledge of business processes and enabling technologies, specifically in a CDM/Charge Capture function.
• Well-developed process design, implementation, and improvement skills.
• Accuracy, attentiveness to detail and time management skills.
• Aptitude to conceptualize, plan, and implement stated goals and objectives.
• Ability to work concurrently on a variety of tasks/projects in a fast paced environment with identified productivity requirements and with individuals having diverse personalities and work styles.
• High-level problem identification/ mitigation/ resolution, analytical and financial skills.
• Ability to develop effective working relationships/ networks within and outside the organization.
• Ability to communicate ideas both verbally and in writing to interact with others using one-on-one contact, formal presentations, and group discussions.
• Ability to use spreadsheet, word processing, statistical, project management, and presentation software applications, preferably Microsoft Suite and knowledge of Patient Management information system applications, preferably EPIC.

Job Shift & Schedule

• Job Shift: Days
• Schedule: Full Time
• Days of the Week: Monday - Friday
• Weekend Requirements: None
• Benefits: Yes
• Unions: No
• Position Status: Exempt
• Weekly Hours: 40
• Employee Status: Regular

Equal Opportunity

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range

Pay Range is $117,436.80 to $176,155.20 / annual salary.

Candidate starting salaries consider multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program.

Benefits

Eligible positions also include a comprehensive benefits package.