Chargemaster Analyst Resume Samples

A Chargemaster Analyst is responsible for the implementation of pricing strategies and strategies for the development and maintenance of charge master databases. They ensure that the chargemaster databases are updated regularly to ensure accurate and compliant billing, reimbursement, and cost containment. Some of the most common duties associated with the post are listed on the Chargemaster Analyst Resume as – analyzing and researching charges and ensuring that the chargemaster databases are compliant with all applicable regulations, including Medicare and Medicaid, creating pricing policies and procedures and implementing fee schedules, as well as updating charge master databases with changes in payer contracts, monitoring reimbursement processes and evaluating cost containment opportunities.

The skills needed for a Charge Master Analyst position include strong analytical, organizational, and communication skills. They should also have excellent knowledge of medical coding and billing regulations, as well as a strong understanding of reimbursement, cost containment, and pricing strategies. A Charge Master Analyst typically needs a bachelor’s degree in finance, accounting, or a related field, as well as at least two years of experience in medical billing and coding. Additionally, they may need to obtain certification in medical coding and billing, such as the Certified Professional Coder.

Chargemaster Analyst Resume example

Associate Chargemaster Analyst Resume

Summary : As an Associate Chargemaster Analyst, Coordinated the set up of Chargemasters and charged sheets for new Departments and/or Practices. Assisted in the development of Hospital System Policies relating to charge entry, price setting, and development of new charge items. Conducted audits to assure all documented charges are being captured and performs audits to confirm that charges are being billed correctly on the claim.

Skills : Analytical Skills, Documentational Skills.

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Description :

  1. Reviewed and maintained hospital Charge Description Master (CDM) data to ensure the accuracy of hospital charges and correct coding assignments.
  2. Worked closely with hospital departments to promote compliance and provide education on charge practices based on regulatory requirements.
  3. Conducted audits reviewing medical record documentation and establishing audit recommendations to improve departmental processes.
  4. Reviewed claim denials, including billing edits, and determined resolution using Medicare coding and compliance regulations.
  5. Collaborated with financial analysts to review and develop hospital charge structure.
  6. Worked in conjunction with other revenue integrity staff or revenue cycle leaders to develop strategies to facilitate appropriate billing of all services.
  7. Maintained and built the CDM for 30+ facilities. Assigned new procedure, supply, and drug codes/changeability.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Healthcare Management


Assistant Chargemaster Analyst Resume

Summary : As an Assistant Chargemaster Analyst, organized, analyzed, and presented data in coordination with clinical, revenue cycle, information technology, and financial management staff to support proper charging practices for all hospital and physician departments, providing accurate, timely, and objective analysis. Oversaw and maintained the hospital and physician chargemaster, charge structure, charge coding, government regulations/compliance, pricing, rate structure and performs ongoing and special financial analysis for management throughout the health system, as assigned.

Skills : Chargemaster, Communicational Skills.

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Description :

  1. Maintained and updated the hospital Chargemaster in order to optimize revenue generation and maintained compliance with third-party requirements. Met with the ancillary departments regularly and conducted internal audits within hospital areas.
  2. Severed as a resource person throughout the hospital for revenue-generating departments.
  3. Supported the Operations Manager in areas pertaining to Reimbursement such as primary contracts for doctor's offices or hospital departments in the tracking of high-cost procedures, maintained spreadsheets in the tracking of reimbursement, and assisted with various reimbursement analyses as needed.
  4. Ran, analyzed, and summarized various CDM reports and distributed them to requesting departments will assist with internal auditing and will provide administrative support for external auditors.
  5. Documented policies & procedures for the Patient Accounting department - Reviewed and approved invoices for services billed to the hospital for processing.
  6. Analyzed and monitored reimbursement on high-cost drugs, Bariatric procedures, Nuclear Medications, Neurostimulators, and Baclofen pumps.
  7. Demonstrated personal commitment to the hospital's core values of service to the poor, reverence, integrity, wisdom, creativity, and dedication through incorporating these competencies in job performance and through involvement in the service excellence process.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Healthcare Management


Junior Chargemaster Analyst Resume

Summary : As a Junior Chargemaster Analyst, Coordinated with the business office to resolve any denial issues related to the Chargemaster. Assisted Revenue Cycle Support Coordinator in other projects and analyses. Served as a member of the Revenue Management team and subscribe to the vision, values and expectations of the Duke University Health System.

Skills : Analyst, Health System.

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Description :

  1. Ran scripts to sync systems. Worked closely with department heads to ensure accurate billing/coding procedures/ maintain reports for budget/billing/review, LCD/NCD policies including CCI edits.
  2. Demonstrated safe working practices and attitudes, follows safety rules, works to prevent unsafe conditions and behaviors, and participates in organizational and departmental safety programs.
  3. Completed appropriate processes and documentation for CDM activity, financial analysis, departmental communications, annual changes, etc.
  4. Conducted quality control audits to ensure data/documentation integrity, communicated findings and recommendations, explained regulatory requirements, and oversaw the corrective actions for audits within the operational units for Charge Description Master.
  5. Compiled information and/or prepare reports and analyses setting forth results of data integrity findings with appropriate recommendations.
  6. Performed and followed up with appropriate health team members to ensure accurate and complete handling of Missing Charges and Billing.
  7. Worked collaboratively with the appropriate operational leaders at each entity to develop necessary education strategies to promote complete and accurate clinical documentation, and charge capture to mitigate and/or correct negative trends.
              Years of Experience
              Experience
              10+ Years
              Experience Level
              Level
              Senior
              Education
              Education
              Healthcare Management

              Senior Chargemaster Analyst Resume

              Objective : As a Senior Chargemaster Analyst, reviewed and revised Hospital Charge master to maximize billings and reimbursement. Prepared management reports, special reports, surveys, statistics, necessary to monitor and evaluate reimbursement. Maintained familiarity with the provision of medical record services, policies, procedures, standards, and coding.

              Skills : Maintenance Skills, Billing.

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              Description :

              1. Built new Hospital Chargemaster Procedures/Supplies specific to Department needs.
              2. Maintained the Hospital Chargemaster according to CMS regulations and compliance on a timely basis.
              3. Followed up and resolved issues related to charting audits within the patient bill providing education, and additional compliance documentation as needed.
              4. Investigated, responded to, and communicated information regarding Departmental coding, documentation, compliance, and reimbursement.
              5. Established new charges in accordance with hospital charging protocols.
              6. Monitored laws and regulations that may impact department activities to ensure all charges bill accurately as mandated.
              7. Established charge codes for all new departments and satellite locations.
                                              Years of Experience
                                              Experience
                                              2-5 Years
                                              Experience Level
                                              Level
                                              Junior
                                              Education
                                              Education
                                              MBA

                                              Chargemaster Analyst Resume

                                              Objective : As a Chargemaster Analyst, Educated Department Managers and/or Practice Managers on compliance and coding regulations. Coordinated with Department Managers and/or Practice Managers on new procedures being performed to assure the charges are set up appropriately and timely and the staff responsible for entering charges is educated.

                                              Skills : Planning, Analyst.

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                                              Description :

                                              1. Developed billing vouchers, and trained staff on accurate charge capture process.
                                              2. Conducted regular audits and provides education to management on the billing and charging processes.
                                              3. Assisted in the identification and resolution of charging issues and related operational practices to ensure compliance with regulatory guidelines.
                                              4. Identified and capitalized on opportunities to increase revenue.
                                              5. Assisted with research and identifies possible issues at the claim level for billing and collection staff.
                                              6. Communicated effectively in both oral and written form. Identified ways to improve work processes and improve customer satisfaction. 
                                              7. Maintained effective interpersonal relationships. Skilled in completing assignments accurately and with attention to detail.
                                              Years of Experience
                                              Experience
                                              2-5 Years
                                              Experience Level
                                              Level
                                              Executive
                                              Education
                                              Education
                                              MBA

                                              Chargemaster Analyst Resume

                                              Objective : As a Chargemaster Analyst, maintained and updated the Chargemaster to comply with federal and state regulations and internal hospital policies. Coordinated with Department Managers and/or Practice Mangers to assure all necessary charges are built in the Chargemaster and performed audits to evaluate if all charges are being captured.

                                              Skills : Coding systems; Certified Healthcare Financial Professional.

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                                              Description :

                                              1. Analyzed, organized, and prioritized work under pressure while meeting deadlines.
                                              2. Prepared and reported data required to obtain appropriate reimbursement from payers.
                                              3. Worked with EPIC IT Teams to improve the accuracy of charge build. Analyzed, compiled, documented, and reported on data and exports. 
                                              4. Informed and provided insights to Management using available data resources.
                                              5. Promoted adherence to applicable State/Federal laws and regulations and the program requirements of accreditation agencies and Federal/State and private health plans in requests for third-party reimbursement. 
                                              6. Researched applicable laws, regulations, and supporting documentation in the analysis of chargemaster, cost reporting, or other governmental reimbursement requests.
                                              7. Reduced risk to Parkland by identifying, documenting, and reporting potential compliance issues within their specific area of accountability, such as analysis of timely contractual and liabilities or chargemaster coding reviews. 
                                              Years of Experience
                                              Experience
                                              2-5 Years
                                              Experience Level
                                              Level
                                              Executive
                                              Education
                                              Education
                                              MBA

                                              Chargemaster Analyst Resume

                                              Summary : As a Chargemaster Analyst, provided analyses for corporate level reimbursement projects as requested by the facilitys Fiscal Director Financial Analyst or PFS Management. Created concise relevant accurate financial and statistical data in support of finance projects as requested.

                                              Skills : Knowledge of medical terminology, Anatomy and physiology.

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                                              Description :

                                              1. Audited, and established processes and procedures to detect errors or irregularities, assuring compliance with laws, regulations, and guidelines of Federal/State programs.
                                              2. Analyzed payer requirements and pursues reimbursement through cost report settlement or charge capture or pricing opportunities.
                                              3. Performed strategic financial planning, using familiarity with payer requirements, to identify third-party monies available through claims or settlement mechanisms.
                                              4. Coordinated data required for external audits, assuring timeliness and completion of projects. 
                                              5. Documented and computed the impact of possible compliance issues according to department procedures.
                                              6. Identified opportunities and make recommendations for interdisciplinary and department process improvement such as analyzing Return to Providers (RTPs) or work queues.
                                              7. Led department teams to implement changes, creating a work plan and department procedures required.
                                              Years of Experience
                                              Experience
                                              7-10 Years
                                              Experience Level
                                              Level
                                              Management
                                              Education
                                              Education
                                              MBA

                                              Chargemaster Analyst Resume

                                              Summary : As a Chargemaster Analyst, provided analytical support related to reimbursement and billing to facility Fiscal Directors and or financial analysts. Developed implements and monitors the chargemaster database systems which enable corporate wide management reporting on financial and operational data.

                                              Skills : HCPCS, and ICD-10.

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                                              Description :

                                              1. Acted as a Revenue Integrity liaison with various EPIC IT teams handling various modules to set up and maintain the accurate flow of charges. 
                                              2. Worked closely with EPIC HB/PB setup teams to review the accuracy of the build.
                                              3. Coordinated or assisted in special projects within the finance area, such as determining the effects of proposed or implemented changes in reimbursement rules or providing support during cost reporting, pricing, or chargemaster maintenance.
                                              4. Maintained positive working relationships with other hospital departments such as Patient Financial Services, Medical Records, Compliance, and the Medical Staff Office to ensure that the responsibilities of the department are performed in an expeditious and thorough manner.
                                              5. Made recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department.
                                              6. Stayed abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrated knowledge gained into current work practices.
                                              7. Maintained knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the area. 
                                                    Years of Experience
                                                    Experience
                                                    7-10 Years
                                                    Experience Level
                                                    Level
                                                    Consultant
                                                    Education
                                                    Education
                                                    Healthcare Management

                                                    Chargemaster Analyst Resume

                                                    Objective : As a Chargemaster Analyst, developed and established facility specific and regional models for financial analyses as related to requested and mandated changes to the chargemaster. Developed reports to evaluate the reimbursement effect of third party payor contract proposals as requested by the facility Fiscal Directors and or financial analysts.

                                                    Skills : Knowledge of healthcare regulations, CPT.

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                                                    Description :

                                                    1. Developed effective internal controls designed to promote adherence to applicable laws, accreditation agency requirements, and federal, state, and private health plans. Sought advice and guidance as needed to ensure proper understanding.
                                                    2. Provided 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. 
                                                    3. Maintained the Scripps Health facility chargemasters within applicable coding guidelines and Scripps Policies and Procedures assisted with bill problem resolution and research and communicates coverage guidelines for billable services. 
                                                    4. Worked with clinical directors and managers to implement and monitor CDM changes. Provides other support to the Manager Chargemaster as needed.
                                                    5. Monitored and maintained hospital departmental chargemasters to ensure coding and billing accuracy of new and existing service codes.
                                                    6. Worked 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.
                                                    7. Performed subsequent audits to ensure complete and appropriate corrective action for the timely completion of missing charges by the department.
                                                                            Years of Experience
                                                                            Experience
                                                                            2-5 Years
                                                                            Experience Level
                                                                            Level
                                                                            Executive
                                                                            Education
                                                                            Education
                                                                            Healthcare Management

                                                                            Chargemaster Analyst Resume

                                                                            Objective : As a Chargemaster Analyst, reviewed Medicare intermediary Compensation and other third-party payor bulletins to keep current on billing requirements. Communicated this information to all applicable departments through each facility's chargemaster task force team.

                                                                            Skills : Analytical, Communication.

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                                                                            Description :

                                                                            1. Developed reports to monitor compliance with department recommendations. Assisted the Patient Financial Services billing personnel in resolving third-party payor billing problems.
                                                                            2. Worked with the Scripps contracting department and third-party payors to resolve problems.
                                                                            3. Participated in the pre-contract review process to insure that all billing requirements can be met.
                                                                            4. Worked with Medicare intermediaries and CMS to clarify billing requirements.
                                                                            5. Documented and tracked all communications and instructions received from government agencies. Communicated this information to all applicable departments.
                                                                            6. Performed periodic reviews of the CMS Medicare fiscal intermediary websites to keep abreast of pending changes.
                                                                            7. Worked with the Chargemaster Steering Committee and affected departments to proactively creates plans to adopt and or implement changes.
                                                                            Years of Experience
                                                                            Experience
                                                                            2-5 Years
                                                                            Experience Level
                                                                            Level
                                                                            Executive
                                                                            Education
                                                                            Education
                                                                            Bachelor's In Finance