Category:

Administrative/Clerical

Schedule:

Full-time

Description

The Charge Master Data Analyst (CMDA) is responsible for maintaining, updating, reviewing and reconciling the charge master for the organization. This role is part of the Patient Business Office but serves the entire organization.

Patient Account

Representative is responsible for managing the financial aspects of healthcare services, including claims processing, payment posting, and patient billing. They ensure accurate and timely reimbursement for healthcare providers by submitting claims to insurance companies, following up on unpaid claims, and managing patient payments. Acts as a liaison between patients, insurance companies, and healthcare providers.

Minimum qualifications:

• High School diploma or GED equivalent preferred.
• Experience and an understanding of charge capture, fee schedules, coding, billing, compliance and basic charge master principles.
• Understanding of laws and regulations as they pertain to coding, billing and pricing preferred.
• Prior medical/clinic billing experience preferred.
• One year computer training and/or experience, accurate typing skills, experience dealing with public and multi-line telephones.
• Computer, telephones, copy and fax machines, printers, 10-key calculator.
• Excellent communication, visual perception and reasoning necessary to accurately interpret changes, guidelines and policies.
• Must work independently and use good judgment when making decisions and recommendations regarding charging/documentation practices.

Primary job responsibilities:

Charge Master Data Analyst (CMDA)

• Charge Master Review.
• Updating and maintaining the charge master.
• Works with CFO on pricing.
• Works with other departments on charge master changes, updates and issues.
• Opening up and managing SR’s related to AR, team and charge master.
• Proactively works assigned reports; suspended charges, GL 999 errors, and other reports as assigned.
• Review and understand regulations regarding to charge master activities.
• Proactively communicates changes, issues, concerns, and updates to charge master.
• Creates policies and procedures related to charge master processes.
• Communicates professionally and clearly with patients, team, leadership and other employees.
• Other duties as assigned.

Patient Account Representative (Medical Biller)

• Initial billing for all insurances; Commercial Regence, Government and Workers' Comp, Medicare, Medicaid, Premera.
• Responsible to know and follow billing instructions by payer/service specific.
• Responsible for follow-up procedures for collection to include phone calls, letters, account adjustments and documentation.
• Verify overpayments and process refunds.
• Investigate and resolve claim denials.
• Submit accurate account adjustments.
• Responsible to work a minimum of 50 accounts each day.
• Edit, validate claims in Rev Manager to be released daily.
• Maintain AR days less than 12% in the 120> aging category.
• Communicate professionally and clearly with patients.
• Other Duties as assigned.

Standard for portrayal of mission and values:

• Employee demonstrates and fosters the Lewis County Hospital District No. 1 core values of - One team, on Mission. Go out of your way, to brighten someone's day. Own it, embrace it. Care like crazy. Motivate, elevate, appreciate. Know the way, show the way, ease the way. Find joy along the way.
• Employee demonstrates and fosters the mission of Lewis County Hospital District No. 1 to foster trust and nurture a healthy community.
• Is cooperative and supportive to others within the department and hospital providing care and services.
• Treats individuals including patients, co-workers, supervisors, management, patient families, physicians, volunteers, visitors and others with respect, dignity and fairness.
• Behaves professionally and ethically in all interactions with patients, co-workers, supervisors, management, patients' families, physicians volunteers, and others.
• Is consistently courteous to patients, co-workers, supervisors, management, patient’s families, physicians, volunteers and others; greets individuals and provides assistance and direction i