Roanoke, Virginia
Miami, Florida
Saint Louis, Missouri, Missouri
Harrisburg, Pennsylvania
La Plata, Maryland
San Antonio, Texas
Posted: 15-Jul-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 140055509
Takeon a key analytical role with a world-class health organization. Drive internalcustomer satisfaction and the efficient processing of hospital charges. Takeyour professional expertise to the next level. You can do all of this and moreat UCLA Health.
Youcan be part of the team responsible for building and maintaining charge masterrecords for the hospital system. You'll ensure that hospital charges areprocessed promptly, accurately, and in compliance with Centers of Medicare& Medicaid Services (CMS), Medi-Cal, and other policies. You'll apply yourextensive knowledge of hospital billing, coding, and pricing practices, as wellas advanced data analysis skills, to monitor, maintain, and improve the chargemaster records. You will:
- Develop and maintain charge codes and prices in partnership with ISSCareConnect teams and Operational Departments.
- Investigate and resolve suspended charge records from CareConnect hospitalbilling work queues assigned to the Charge Description team.
- Create new charge records as needed for new CareConnect applications. Participate in developing testing scenarios. Validate testing procedures to ensure that new workflows generate charges properly.
- Conduct quarterly, annual, or as-needed reviews to ensure that the ChargeDescription Master is updated for new and revised CPT4/HCPCS codes.
- Comply with the Charge Master Department's policy and procedures relatedto charge codes and descriptions.
- Effectively coordinate and facilitate user interaction with CareConnect teams to define and validate processes that assure effective and efficient charge flows.
- Maintain files that contain the audit trail of Charge Description Masteradditions, updates, and other changes.
- Collaborate with the Revenue Capture, Revenue Integrity, and HB teams onthe routine review of charge capture processes.
- Manages and conducts special project reviews.
- Maintain compliance with CMS, Medi-Cal, and health plan billing regulations.
- Analyze complex billing/financial data.
- Summarize data and present findings to leadership.
Note: This posted position is 1 of 2 positionsavailable for hire. All applicants will apply through this requisition and ifselected will be hired into one of the available positions.
We'reseeking an adaptable, knowledgeable, and highly analytical individual with:
- CCS, CPC-O, CPCcertification or related coding education
- Bachelor's degree in business,finance, or related field, preferred
- Eight or more years ofexperience in hospital finance, billing, coding, revenue integrity, medicalanalysis, or medical auditing
- Prior experience and/orknowledge of regulations on charging and billing practices for Medicare,Medi-Cal, and other payers (UB04 and/or CMS1500)
- Experience with EPICcharge master and familiarity with CDM structure, content, and maintenance, aswell as in revenue integrity operations, clinical charge capture, or revenuecycle operations
- Knowledge of CPT,HCPCS, and Medi-Cal coding guidelines and regulations; ability to utilize relevantreference resources (e.g., Federal Register, CMS memorandums, etc.)
- Proficiency in the useof Current Procedural Terminology (CPT), Healthcare Common Procedure CodingSystem (HCPCS), and revenue codes
- Understanding ofcompliance issues and their importance and consequences
- Knowledge of EPICsystem, particularly Resolute Hospital Billing
- Advanced knowledge ofMicrosoft Office
- Experience with projectprocesses and facilitation of teams
- Background in projectmanagement preferred.
- Strong analytical,problem-solving, communication, interpersonal, and collaboration skills
UCLAHealth is a world-renowned health system with four award-winning hospitals andmore than 270 community clinics throughout metro Los Angeles as well as theDavid Geffen School of Medicine. Through the efforts of our outstanding people,we have become Los Angeles' trusted provider of exceptional, compassionatepatient care. If you're looking to experience greater challenge and fulfillmentin your career, you can at UCLA Health.
