Manager Chargemaster

Manager Chargemaster

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.

Required Qualifications and Experience:

1. 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

2. Extensive knowledge of CPT/HCPCS/UB-04 revenue coding, modifiers, CMS billing regulations and APCs

3. Ability to work under minimal supervision with a demonstrated accuracy and precision essential to detailed work

4. Ability to assist in the development, recommendation and execution of strategic pricing models

5. Strong computer application skills with advanced knowledge of Excel spreadsheet functions

6. Strong quantitative and analytical skills

7. Strong organizational skills with the ability to manage large amounts of data in a manner that facilitates timely sharing of information

8. In-depth knowledge of complex, outpatient procedure terminology

9. Ability to understand and interpret medical records and hospital bills

10. Ability to understand ancillary department functions

11. Strong understanding of the chargemaster relationship to related areas such as Cost Center Assignment, Costing and Pricing Methodologies and Medicare Regulations

12. Ability to execute and analyze various pricing strategies for the chargemaster

13. Excellent communication, oral and written, and project management skills

14. 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

CPC, CPC-H/COC, CCS active certifications and/or Registered Nurse with relevant revenue cycle experience

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.