At Scripps Health, you will experience the pride, support, respect that has been repeatedly recognized as one of the nation's Top 100 Places to work.

You'll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you're open to change, go ahead and unlock your potential.

If you are seeking a role that makes an impact on healthcare and a Nationally ranked hospital, this is the position for you. The ideal candidate would be someone who is able to manage time efficently and work to meet the needs of demand.

The Chargemaster Senior Analyst provides assistance and analysis to all levels of clinical management at Scripps in support of suggested requested and or mandated changes to the Charge Description Master CDM. This support includes development of data analysis and recommendations to minimize negative effects of change. Maintains the Scripps Health facility chargemasters within applicable coding guidelines and Scripps Policies and Procedures assists with bill problem resolution and researches and communicates coverage guidelines for billable services. Works with clinical directors and managers to implement and monitor CDM changes. Provides other support to the Manager Chargmaster as needed.

CDM responsibilities include but are not limited to:

• Monitors and maintains hospital departmental chargemasters to ensure coding and billing accuracy of new and existing service codes.
• Working with clinical directors and managers to implement and monitor CDM changes. Evaluates department requests to insure that all additions, changes and deletions are consistent with proper charging coding practices.
• Working with clinical directors and managers to insures the appropriate bundling or unbundling of charges so that all charges are submitted to result in appropriate reimbursement while following applicable billing reimbursement regulations.
• Developing reports to monitor compliance with department recommendations. Assists the Patient Financial Services billing personnel in resolving third party payor billing problems.
• Working with the Scripps contracting department and third party payors to resolve problems.
• Participating in the pre contract review process to insure that all billing requirements can be met.
• Working with Medicare intermediaries and CMS to clarify billing requirements.
• Documenting and tracking all communications and instructions received from government agencies. Communicates this information to all applicable departments.
• Reviewing all Medicare and Medi Cal newletters updates performs periodic review of the CMS Medicare fiscal intermediary web sites to keep abreast of pending changes.
• Working with the Chargemaster Steering Committee and affected departments to proactively creates plans to adopt and or implement changes.
• Reviewing Medicare intermediary Medi Cal California Workers Compensation and other third party payor bulletins to keep current on billing requirements.
• Communicating this information to all applicable departments through each facility's chargemaster task force team.

Senior Analysis duties include but are not limited to:

• Initiating develop and establish facility specific and regional models for financial analyses as related to requested and mandated changes to the chargemaster.
• Developing reports to evaluate the reimbursement effect of third party payor contract proposals as requested by the facility Fiscal Directors and or financial analysts.
• Providing analytical support related to reimbursement and billing to facility Fiscal Directors and or financial analysts.
• Developing implements and monitors the chargemaster database systems which enable corporate wide management reporting on financial and operational data.
• Providing analyses for corporate level reimbursement projects as requested by the facility's Fiscal Director Financial Analyst or PFS Management.
• Creating concise relevant accurate financial and statistical data in support of finance projects as requested.

This is a Full Time (80 hours every two weeks) benefited and salaried position. Located at Scripps Corportae offices in San Diego.

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Required Qualifications:

• Five years experience in an acute care setting and coding certification, CCS, CPC, CPC-H, RHIT, RHIA required, or must be obtained within 12 months of hire; OR
• Bachelors' Degree (preferred in health-care related field, business, finance or accounting) ; OR
• Associates Degree or Health Care Professional License (i.e. nursing, radiology, respiratory therapy); OR
• Five years procedural coding for Medicare, Medi-Cal and California Workers Compensation in an acute care setting.
• Advanced working knowledge of MicroSoft Office Programs (Word, Excel, Access, Powerpoint), MultiEntitiy, Last Word, and Ancillary downstream systems (RMS, Dominator, MacLab) WinTask and other software for researching issues concerning CDM maintenance.
• Knowledge of HCPCS coding and revenue coding required.
• Demonstrated knowledge of medical terminology.
• Personal characteristics of success in this function include:
• Proven ability to engineer and initiate change.
• Demonstrates experience in working with large database, particularly extracting and manipulating specific files.
• Expertise of HCPCS coding and revenue coding with an ability to interpret and apply Medicare and Medi-Cal and other third-party payor billing regulations. Demonstrates exceptional analytical skills.
• Must be able to understand complex billing situations that arise with a multi-facility hospital organization that provides a wide range of diagnostic and therapeutic modalities.
• Must have a thorough understanding of medical terminology and be able to apply this knowledge to a wide range of therapeutic and diagnostic situations.
• Highly developed interpersonal and communication skills (both written and verbal).Must be able to interact tactfully and effectively with physicians, clinicians, nurses and others both inside and outside of the Scripps Health organization on sensitive and/or complex topics.
• Ability to prioritize plans and initiates multiple tasks and projects.
• Must be able to work independently, be a self-starter, and self-motivated. Demonstrated ability to provide leadership in team situations.
• Demonstrated ability to direct individuals within the Scripps Health facilities in order to achieve departmental objectives.

Required Education/Course(s)/Training/Certification/Registration:

• Coding certification CPC, CPC-H (AAPC) or CCS (AHIMA), or must be obtained within 12 months of hire.
• Bachelors Degree, preferrably in Health Care related field, Business, Finance or Accounting OR A degree or certificate in nursing or in an ancillary therapeutic or diagnostic patient care field may be substituted; OR Acute Care code education.