UCLA Health • Los Angeles, CA 90006
Job #2819259080
Description
Take
on a key analytical role with a world-class health organization. Drive internal
customer satisfaction and the efficient processing of hospital charges. Take
your professional expertise to the next level. You can do all of this and more
at UCLA Health.
You
can be part of the team responsible for building and maintaining charge master
records for the hospital system. You'll ensure that hospital charges are
processed promptly, accurately, and in compliance with Centers of Medicare
& Medicaid Services (CMS), Medi-Cal, and other policies. You'll apply your
extensive knowledge of hospital billing, coding, and pricing practices, as well
as advanced data analysis skills, to monitor, maintain, and improve the charge
master records. You will:
Develop and maintain charge codes and prices in partnership with ISS CareConnect teams and Operational Departments.
Investigate and resolve suspended charge records from CareConnect hospital billing 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 Charge Description Master is updated for new and revised CPT4/HCPCS codes.
Comply with the Charge Master Department's policy and procedures related to 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 Master additions, updates, and other changes.
Collaborate with the Revenue Capture, Revenue Integrity, and HB teams on the 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.
Salary Range: $78,800-$175,000/annually
Note: This posted position is 1 of 2 positions
available for hire. All applicants will apply through this requisition and if
selected will be hired into one of the available positions.
Qualifications
We're
seeking an adaptable, knowledgeable, and highly analytical individual with:
CCS, CPC-O, CPC certification or related coding education
Bachelor's degree in business, finance, or related field, preferred
Eight or more years of experience in hospital finance, billing, coding, revenue integrity, medical analysis, or medical auditing
Prior experience and/or knowledge of regulations on charging and billing practices for Medicare, Medi-Cal, and other payers (UB04 and/or CMS1500)
Experience with EPIC charge master and familiarity with CDM structure, content, and maintenance, as well as in revenue integrity operations, clinical charge capture, or revenue cycle operations
Knowledge of CPT, HCPCS, and Medi-Cal coding guidelines and regulations; ability to utilize relevant reference resources (e.g., Federal Register, CMS memorandums, etc.)
Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes
Understanding of compliance issues and their importance and consequences
Knowledge of EPIC system, particularly Resolute Hospital Billing
Advanced knowledge of Microsoft Office
Experience with project processes and facilitation of teams
Background in project management preferred.
Strong analytical, problem-solving, communication, interpersonal, and collaboration skills
UCLA
Health is a world-renowned health system with four award-winning hospitals and
more than 270 community clinics throughout metro Los Angeles as well as the
David Geffen School of Medicine. Through the efforts of our outstanding people,
we have become Los Angeles' trusted provider of exceptional, compassionate
patient care. If you're looking to experience greater challenge and fulfillment
in your career, you can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.
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