Revenue Integrity Chargemaster Analyst

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Location 680 Lake Shore Drive Job Description General Summary: The Revenue Integrity Chargemaster Analyst is responsible for maintaining the integrity of revenue capture system for the organization. Maintaining an accurate and compliant charge capture system is critical to the fiscal strength of the organization. Conducts prospective audits of patient’s charts to ensure billing accuracy. Essential Job Functions Oversees maintenance of the chargemaster (CDM). Reviews, approves and builds all new charges. The review includes CPT (Current Procedural Terminology) codes, HCPCS codes, pricing, revenue codes and appropriate usage. Ensures all charges are tested and fully integrated with other systems as appropriate. Examples include supply systems, department preference lists, etc. Updates the CDM annually based on changes published by the AMA (American Medical Association) via CPT guidelines; updates quarterly based on CMS (Centers for Medicare and Medicaid) guidelines for HCPCS codes (Healthcare Common Procedure Coding System). Acts as primary liaison to clinical departments for annual CPT/HCPCS updates and ad hoc changes. Works with Information Management to ensure new and deleted codes are implemented appropriately. Acts as a resource to revenue generation departments in establishing new charges and/or questions around existing charges. Develops coding education for internal departments. Oversees billing edit processes including CCI and MUE, along with other revenue capture initiatives captured by edits. Collaborates with departments on developing process changes to reduce pre-bill edits and achieve clean claims. Tracks edit volumes by type and department to identify and assist with resolutions as necessary. Reviews CDM departments on a regular basis or as defined in the Revenue Integrity Workplan. Review includes accuracy of charge use, review of charges available, charge reconciliation, and identifying opportunities and deficiencies. Works with a multidisciplinary committee to oversee and implement the annual price increase for organization. Ensures all fee schedules are updated accurately. May include working with consultants and the involvement of department leadership. Collaborates with all levels in the organization regarding opportunities and/or deficiencies. Provides recommendations for improvement and provides education as necessary. Performs follow up review to ensure implementation of improvements. Develops corrective action plans and participates in compliance investigations as needed. Assists with the annual Revenue Integrity Workplan development and ensures adherence to the workplan. Maintains an understanding of current Medicare, Medicaid, and commercial payer billing regulations and implements changes as related to CDM. Develops understanding of charge triggering systems used throughout the organization. Participates in projects, committees and system upgrades as necessary. Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. Other job functions as assigned. Knowledge, Skills and Abilities Bachelor’s degree required, master’s degree preferred. Appropriate experience and/or training may be accepted in lieu of educational requirements. Qualifications Coding Credential required within 6 months of employment. Coding credential require: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), Certified Coding Specialist – Physician Based (CCS-P) Clinical discipline preferred. 3 years CDM experience required. Epic CDM experience preferred. Epic Certification in Charge Capture required within one year. Strong analytical and financial skills required. Proficient with Microsoft Office: Excel, Word and Power Point. Strong verbal and written communication skills required. Has working knowledge of clinical operations in a complex academic environment. Strong research skills and the ability to understand and interpret billing and documentation regulations. Ability to work independently and creatively. Maintain independence, objectivity and professional skepticism. Comfortable with using computers including the EMR. Knowledge of billing processes used in healthcare organizations. Education Bachelor's Degree: Finance (Required) Pay Range $65,520.00-$107,120.00 Salary At Lurie Children’s, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits. Benefit Statement Medical, dental and vision insurance Employer paid group term life and disability Employer contribution toward Health Savings Account Flexible Spending Accounts Paid Time Off (PTO), Paid Holidays and Paid Parental Leave 403(b) with a 5% employer match Supplemental Life, AD&D and Disability Critical Illness, Accident and Hospital Indemnity coverage Tuition assistance Student loan servicing and support Adoption benefits Backup Childcare and Eldercare Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members Discount on services at Lurie Children’s facilities Discount purchasing program We’re a Place for You with Us At Ann & Robert H. Lurie Children’s Hospital of Chicago and its affiliates (collectively “Lurie Children’s”), we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care. Equal Employment Opportunity Lurie Children’s and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. EEO Statement All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law. Contact for Accommodation For questions about how to request an accommodation please contact: View email address on click.appcast.io AI Notice Lurie Children’s utilizes certain AI-enabled features within our recruiting platform to support candidate engagement and assist recruiters in identifying and prioritizing applicants whose experience aligns with job requirements. All employment decisions are made by individuals. It is a civil rights violation with respect to recruitment, hiring, promotion, or employment for an employer to use artificial intelligence that has the effect of subjecting employees to discrimination on the basis of protected classes under the Illinois Human Rights Act or to use zip codes as a proxy for protected classes. For questions about the use of artificial intelligence in this process or any additional support, please contact: View email address on click.appcast.io Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. #J-18808-Ljbffr 10 HOSP Ann & Robert H. Lurie Children's Hospital of Chicago