Charge Master Specialist, Observation Charge Audit

Sutter Health; United States; Remote; USD 117,000 - 176,000; Full time

Benefits offered by this job

Benefits package

Job summary

Sutter Health is seeking a charge capture/charge description master expert to partner with clinical service line leaders across Interventional Radiology, Operating Room, and Observation to standardize charge capture and ensure payer-compliant reimbursement.

The role leads reconciliation, conducts best-practice research, and identifies initiatives to improve revenue management, working in a fast-paced environment with cross-functional teams.

Qualifications

• 5 years of relevant experience in charge capture or CDM.
• Deep knowledge of medical billing terms and coding systems.
• Familiarity with government and commercial payer requirements.
• Ability to develop service line education materials.
• Strong analytical and financial skills.

Responsibilities

• Serve as charge capture expert for Interventional Radiology, OR, or Observation lines.
• Standardize charge capture processes across service lines.
• Perform charge reconciliation and identify improvement opportunities.
• Collaborate with clinical leaders to optimize reimbursement.
• Monitor revenue management and compliance with payer rules.

Skills

Charge capture

Billing terminology

Revenue codes

Analytical skills

Financial skills

Communication

Payer requirements

EPIC

Education

Bachelor’s in Health Information

Tools

EPIC

Microsoft Office

Job description

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:

Requirement dependent on the service line supported (to be determined and maintained by hiring manager):

• RN-Registered Nurse of California
• OR RHIT-Registered Health Information Technician
• OR RHIA Registered Health Information Administrator
• OR CPC-Certified Professional Coder
• OR COC- Certified Outpatient Coder
• OR 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 on-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:

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

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

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

The posted pay range is based on the position’s primary work location. Candidates who reside and work outside of that location may be subject to a different pay range based on their work location. 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. Eligible positions also include a comprehensive benefits package.