The Manager of the Chargemaster position within the Department of Finance - Charge Integrity is responsible for maintaining an accurate and complete charge description master, for both hospital and professional billing, and reports to the Assistant/Associate Director of Charge Integrity to supervise and perform data analysis, periodic audits, information queries, external audits and other special projects necessary to optimize revenue generation and maintain compliance with governmental and third party payer requirements.
Principal Duties and Responsibilities:
Provides leadership guidance to the Chargemaster team by coordinating, monitoring and approving all changes to the Chargemaster;
Mentors and trains new staff on learning clinical and billing system workflows and daily tasks related to the management of the chargemaster;
Manages and performs all daily activities performed by the chargemaster specialist role to ensure requests for new charges and regulatory updates are completed accurately and timely;
Supervises and monitors changes to regulatory requirements for the entire patient revenue cycle (i.e., CMS bulletins, transmittals, etc.) and updates the chargemaster timely;
Assists service lines with standardizing charge capture processes and builds related to chargemaster change requests for new procedures and supplies (implants);
Assists Charge Integrity team and Billing Office in identification of missing devices/missing procedures that are discovered through various applications or from internal customers;
Performs queries of data to assist in the resolution of CDM related billing and coding questions;
Interacts with various hospital ancillary and clinical departments to provide education on procedures to maintain charge and reconciliation processes that are compliant; and
Works closely with the Charge Integrity team, VUMC billing offices (professional and technical billing), VUMC Informatics, coding staff, Managed Care Contracting, and clinical departments to ensure updates to the Chargemaster are made in an efficient and accurate manner and proactively communicated.
Bachelor's degree (or relevant work experience substitution for education) with a minimum of six (6) years of experience in the healthcare industry and at least two years of experience in a hospital and/or professional chargemaster role with a combination of clinical, coding and/or billing experience strongly preferred
Extensive knowledge of CPT/HCPCS/UB-04 revenue coding, modifiers, CMS billing regulations and APCs
Ability to work under minimal supervision with a demonstrated accuracy and precision essential to detailed work
Ability to assist in the development, recommendation and execution of strategic pricing models
Strong computer application skills with advanced knowledge of Excel spreadsheet functions
Strong quantitative and analytical skills
Strong organizational skills with the ability to manage large amounts of data in a manner that facilitates timely sharing of information
In-depth knowledge of complex, outpatient procedure terminology
Ability to understand and interpret medical records and hospital bills
Ability to understand ancillary department functions
Strong understanding of the chargemaster relationship to related areas such as Cost Center Assignment, Costing and Pricing Methodologies and Medicare Regulations
Ability to execute and analyze various pricing strategies for the chargemaster
Excellent communication, oral and written, and project management skills
Must be able to multi-task complex projects
Preferred Qualifications and Professional Certifications :
At least three (3) years in a supervisory/management role in a healthcare related field
Three years of operational performance improvement and/or project management experience
Experience with EPIC Chargemaster and Craneware applications
Experience with EPIC HB Resolute Billing Module
Experience with EPIC PB Resolute Billing Module
Discover Vanderbilt University Medical Center:
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity -- of culture, thinking, learning and leading -- is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
VUMC Recent Accomplishments
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
* US News & World Report: #1 Adult Hospital in Tennessee and metropolitan Nashville, named to the Best Hospitals Honor Roll of the top 20 adult hospitals, 10 nationally ranked adult specialty programs, with 3 specialties rated in the top 10 nationally, Monroe Carell Jr. Children's Hospital at Vanderbilt named as one of the Best Children's Hospital in the nation, with 10 out of 10 pediatric specialties nationally ranked.
* Healthcare's Most Wired: Among the nation's 100 "most-wired" hospitals and health systems for its efforts in innovative medical technology.
* Becker's Hospital Review: named as one of the "100 Great Hospitals in America", in the roster of 100 Hospitals and Health Systems with Great Oncology Programs and to its list of the 100 Hospitals with Great Heart Programs.
* The Leapfrog Group: One of only 10 children's hospitals in the to be named at Leapfrog Top Hospital.
* American Association for the Advancement of Science: The School of Medicine has 112 elected fellows
* Magnet Recognition Program: Received our third consecutive Magnet designations.
* National Academy of Medicine: 22 members, elected by their peers in recognition of outstanding achievement
* Human Rights Campaign Healthcare Equality Index: 6 th year in a row that Vanderbilt University Medical Center was a Leader in LGBTQ Healthcare Equality.
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period. Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As t...he largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.
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