Applicants must reside in the United States and be a US citizen or green card holder.
EdiPhy Midwest, a leading provider of knowledge-based services to the healthcare industry, is currently recruiting for a skilled full-time Chargemaster Analyst Consultant to join our team.

JOB SUMMARY:

Chargemaster analyst consultants conduct in-depth evaluation of hospital chargemaster files and charge capture assessments. Consultants have expertise in auditing revenue codes, CPT/HCPCS codes, charge descriptions, and modifiers that are assigned to charges in all ancillary departments.

EXPERIENCE:

• Must have 3 years of experience in hospital chargemaster maintenance. Experience as a coordinator is a plus!
• Must have 3 years of experience in hospital or professional based CPT-4, HCPCS Level II coding and Outpatient ICD-10-CM coding experience for multiple hospital departments.
• Knowledge of OPPS reimbursement methodologies, along with thorough knowledge of Medicare reimbursement and billing guidelines. 
• Knowledge of NUBC revenue codes, mapping structures and extensive experience with UB-04 claim and payment remittance advice statements are required. 
• Knowledge of Medical Necessity of services through the CMS Local and National coverage Determinations
• Experience with CMS transmittals and manuals.
• Experience with the cms.gov website for quarterly HCPCS, OCE, and MUE updates
  Certifications and Licensure: Must have at least one coding credential through AHIMA, AAPC or HFMA.
  Physical Demands: Prolonged periods of sitting at a desk and working on a computer.
  Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Application Question(s):

• What is your state of residence?

License/Certification:

• Medical Coding Certification (Required)

Work Location: Remot

• Abide by the AAPC and AHIMA’s Standards for Ethical Coding and Confidentiality tenets.
• Auditing of charges, documentation, coding and billing practices for hospital services to determine improvement opportunities based on official guidelines and company policies.
• Evaluation of client hospital chargemasters (overall and department specific) making recommendations for additions, deletions and revisions as needed.
• Provide classroom or webinar education for hospital staff regarding correct charging, documentation and coding practices for compliant reimbursement.
• Prepare PowerPoint presentations by gathering and analyzing data for hospital CDM department staff members and leadership.
• Prepare client action plans and reports.
• Schedule follow-up reviews based on the need for re-assessment.
• Keep up with coding guidelines changes from AMA, AHA and other resources assigned.
• Attend education seminars as requested by the VP of Outpatient Services.
• Participate in all staff meetings and training sessions (two staff meetings per year with Outpatient Team meetings as needed).
• Ability to work without direct supervision and understand the need for professionalism and ethics in all situations.
  Other responsibilities as assigned. Duties may be subject to change at any time at the discretion of management, formally or informally, verbally or in writing.