Senior Systems Specialist, Chargemaster

Job Description

At NorthBay Health, the Senior System Specialist, Chargemaster, is instrumental in ensuring a compliant and accurate Chargemaster across the organization. This role with serve as an expert and liaison between finance, clinical departments, and hospital-based clinics on all CDM matters. You will actively drive and assist compliance by overseeing system data revisions, participating in high-priority CDM projects and meetings, and assisting in the development and delivery of training sessions for system staff. This position directly contributes to optimizing our revenue cycle and upholding critical regulatory standards.

PRIMARY JOB DUTIES

• Manages the chargemaster's long term integrity, including pricing for CPT and HCPC codes. Manages all updates and modifications to the CDM
• Assists with chargemaster configurations across all relevant software applications
• Assists with cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant chargemaster across all integrated systems.
• Develops and implements comprehensive policies, procedures, tools and forms to support efficient chargemaster maintenance.
• Assists with implantation of comprehensive policies, procedures, tools and forms to support efficient chargemaster maintenance.
• Assist department with chargemaster compliance, including all auditing and quality assurance activities.
• Assists with cross-functional meetings with key stakeholders including patient financial services, information systems, health information management and clinical departments to proactively analyze error reports, audit findings and regulatory updates.
• Follow up on outstanding issues and tasks, facilitating meeting with relevant hospital department and administrative representatives to implement necessary corrections. Escalates issues to the Manager, Revenue Integrity as appropriate
• Assists with ongoing billing compliance, reviewing billing manuals and regulatory requirements with staff and departments as needed.
• Leads preparation, education, implementation and ongoing monitoring of changes to APC's, DRG's and all payer fee schedules. This includes researching complex reimbursing issues and collaborating directly with department directors to ensure seamless adaptation and compliance.
• Assists with chargemaster compliance initiatives, assist with any investigatory activities and findings that relate to billing chargemaster data.
• Assists with the maintenance of CDM software applications.
• Collaborates with IT and relevant department to optimize the efficiency and functionality of charge services activities interfaces.
• Assists with training on batch charge entry procedure to relevant users.
• Provides regular updates to the Revenue Integrity manager.
• Enhances professional growth and development through educational programs, seminars, etc.
• Performs regular department audits to maximize and ensure the accuracy if charge capture.

Qualifications

3. Skills : Strong organizational and meeting facilitation skills. Strong project management capabilities. Ability to read and interpret regulatory information related to billing of CDM data. Proficient in MS office applications, especially Excel, PowerPoint, Word and Access. Knowledge of internet and government websites required.

About Us

At NorthBay Health, we are guided by our values : Nurturing Care; Own It; Respect; Build Trust; and Hardwire Excellence. These principles lead us to our TRUE NORTH and inspire us to provide exceptional care.

These values serve as the foundation of everything we do, guiding us to deliver individualized care with integrity and accountability. We are committed to fostering a culture of collaboration, where every team member is valued and empowered to contribute their best to the health and well-being of those we serve.

This is an exciting time to join NorthBay Health.

As an independent, nonprofit health system north of the San Francisco Bay Area, in the Napa / Solano Region, we are expanding our footprint across Solano, Yolo, and Napa counties to meet the evolving needs of our communities. With two acute-care hospitals-including a Level II Trauma Center and a modern maternity unit with a Level III Neonatal Intensive Care Unit (NICU)-along with a comprehensive cancer center, multiple urgent care facilities, and a growing network of primary and specialty clinics, we are investing in the future of care across the region.

NorthBay Health we are home to advanced clinical programs and nationally recognized cardiovascular, neuroscience, and orthopedic services, as well as comprehensive surgical and outpatient specialties. Our commitment to excellence is reflected in our Magnet with Distinction designation for nursing (one of only 12 organizations nationwide) and recognition from U.S. News & World Report as "High Performing" in multiple clinical areas, including maternity care, heart failure, and stroke. NorthBay Medical Center has earned the High Performing designation in maternity care for four consecutive years.

As the only locally governed health system in the region, we remain deeply rooted in our communities while growing into a trusted regional healthcare leader. If you are seeking meaningful work, collaborative teams, and the opportunity to help shape the future of healthcare in Northern California, you will find it at NorthBay Health.

Join us with our commitment to excellence, to achieve our vision to be the trusted healthcare partner of choice for the communities we serve.

To learn more about NorthBay Health's benefits, diversity statement and community please visit