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Bozeman Health ELECTRONIC DATA INTERFACE & CHARGEMASTER COORD in Bozeman, Montana

  • POSITION DESCRIPTION

  • POSITION SUMMARY

  • The Patient Financial Services EDI and Chargemaster Coordinator is responsible for the coordinating and managing the implementation and support of PFS and Admitting solutions. Will make recommendations for improvements based on exisitng operating procedures or development of new ones. Responsible for resolving system problems, writing reports, and initiating changes as needed. Ensures all policies/procedures, rules and regulations are followed when developing or modifying charges in the chargemaster. Assists in capturing revenue integrity opportunities.

  • REQUIREMENTS

  • EDUCATION

  • Required:

    • Associate degree or equivalent work experience.
  • Preferred:

    • Specialized courses and/or certification within the healthcare industry
  • LICENSURE and CERTIFICATION

  • Required:

  • Preferred:

  • EXPERIENCE

  • Required:

    • Minimum of 4 years experience in all PFS related functions to include; Registration, Billing, Payment posting, and Practice Management software.
  • Working knowledge of Medical Terminology, ICD9, CPT4 and HCPCS

  • Excellent interpersonal communication sklls.

  • Preferred:

    • CPC, CCS-P or AHIMA certification as a Coder
  • KNOWLEDGE OF, SKILLS IN, ABILITY TO, COMPLEXITY AND DIFFICULY:

  • KNOWLEDGE OF:

    • Working knowledge of Hospital and Clinic billing requirements and systems to include Meditech and Next Gen
  • Knowledge of third-party billing, reimbursement and follow-up

  • Knowledge to effectively interpret organization policies and procedures within the organziation to ensure proper system set up for billing, collections, payment posting, customer service and chargemaster set up.

  • Knowledge of the work flow in each PFS area.

  • Knowledge of Coding regulations for chargemaster build.

  • SKILLS IN:

    • Project management, issue resolution and task prioritization.
  • Create and analyze reports to validate data.

  • Keeps Director of Patient Financial Services informed of any problems or concerns.

  • Perform on-going quality reviews to identify problem areas within the revenue cycle and report back to the Director of Patient Financial Services

  • Proven training experience

  • Skill in problem solving and conflict resolution

  • Intermediate to expert knowledge of Excel and Microsoft Word

  • Business process documentation

  • ABILITY TO:

    • Ability to read and evaluate Healthcare Receivables Information
  • Ability to work with, develop, and maintain relationships with staff, management, clinicians and vendors.

  • Learn quickly.

  • Ability to work with departments on new charge code creation and maintenance.

  • Ability to adapt to changing circumstances in day-to-day operations Ability to prioritize work assignments to meet efficiency standards

  • COMPLEXITY AND DIFFICULTY:

  • ESSENTIAL FUNCTIONS

  • 50% Time Spent - Works with end users, departments and vendors to implement, manage, resolve issues and redesign process flows within PFS and Admitting.

  • 20% Time Spent - Report creation and data validation.

  • 10% Time Spent - Coordinates with members to make decisions and carry out application, build, testing, implementation and ongoing support

  • 10% Time Spent - Manages the chargemaster and related fee schedules, including annual and quarterly updates.

  • 5% Time Spent - Coordinates with Patient Financial Services to ensure pre-bill and billing edits are established in coordination with procedure code and fee schedule setup..

  • 5% Time Spent - Acts as a resource within the organization for chargemaster, revenue integrity and billing related issue

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