GENERAL OVERVIEW:
This job is responsible for ensuring that the health system maintains financial health through a complete and accurate charge listing and charging process maintaining compliance with all federal and regulatory requirements.
ESSENTIAL RESPONSIBILITIES:
- Oversees health system charge description master, ensuring all chargeable activities are reflected appropriately in the Charge Description Master (CDM). (20%)
- Directs and oversees plan to move hospitals from legacy systems to EPIC with a consolidated Charge Description Master (CDM). (20%)
- Monitors, evaluates and updates CDM pricing associated with reimbursement changes and strategic initiatives. (20%)
- Oversees revenue integrity of clinical departments providing education, training and tools for departments to successfully capture clinical into charge capture. (20%)
- Supervises revenue integrity team providing direction and guidance that fosters a team environment through training, recognition/evaluation and in-service education which produces optimum work habits. Mentors and coaches to achieve highest level of competency of leadership and staff. (10%)
- Prepares, monitors, and maintains an annual expense budget. (10%)
QUALIFICATIONS:
Minimum
- Bachelor's degree in Finance or Health related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
- EPIC certification in CDM
- Five years healthcare coding/revenue integrity experience
- Three years leadership experience
Preferred
- RHIA
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$56.98Pay Range Maximum:
$91.17Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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