Job Description

At NorthBay Healthcare the Senior Systems Analyst, Chargemaster is responsible for ensuring a compliant Charge Master (CDM) data file and for the maintenance of the files within all affected software applications. Responsible for maintaining Chargemaster compliance in accordance with regulatory guidelines.

The Senior Analyst serves as a liaison between Finance and all clinical hospital departments including hospital based clinic departments, providing expert guidance on all Chargemaster related issues. Acts as an application and subject matter expert and resource for System Managers in the area of Chargemaster related issues.

Serves as a leader in Charge Master meetings and related projects. Conducts and/or oversees data entry of Charge Master revisions. Directs Chargemaster training sessions for System staff as needed. This role involves actively participating in and leading Chargemaster meeting, projects, overseeing data revisions, and directing training sessions for system staff to maintain regulatory compliance and optimize revenue integrity.

PRIMARY JOB DUTIES

1. Manages the chargemaster’s long term integrity, including pricing for CPT and HCPC codes. Manages all updates and modifications to the CDM
2. Serves as the lead subject matter expert for Chargemaster pricing during annual reviews.
3. Manages chargemaster configurations across all relevant software applications
4. Drives cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant chargemaster across all integrated systems.
5. Drives the timely implementation for all annual CPT, HCPCS, and modifier updates ensuring organizational readiness and regulatory compliance for chargemaster data.
6. Develops and implements comprehensive policies, procedures, tools and forms to support efficient chargemaster maintenance.
7. Accountable for the integrity of the chargemaster compliance, including all auditing and quality assurance activities.
8. Facilitates 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. EN sures the ongoing accuracy and compliance of the chargemaster.
9. 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.
10. Ensures ongoing billing compliance by reviewing billing manuals and regulatory requirements with staff and relevant hospital departments and by providing continuous education to adhere to all contractual and regulatory stipulations.
11. 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.
12. Oversees chargemaster compliance initiatives, collaborating closely with the compliance office to monitor investigatory activities and findings that relate to billing chargemaster data.
13. Manages and submits all the required HCAI CDM information, ensuring timely file submission in accordance with regulatory timelines.
14. Develops new CDM item and service pricing strategies informed by market and competitor research.
15. Provides monthly CDM updates to the organization. Manages the maintenance of CDM software applications.
16. Manages the annual pricing strategy project, overseeing all activities from planning to the implementation of revisions.
17. Collaborates with IT and relevant department to optimize the efficiency and functionality of charge services activities interfaces.
18. Develop and delivers training on batch charge entry procedure to relevant users.
19. Provides regular updates to Manager, Revenue Integrity.
20. Enhances professional growth and development through educational programs, seminars, etc.

Preform regular department audits to maximize and ensure the accuracy if charge capture

1. Education Bachelor’s Degree in Computer Systems, Business, Nursing or 8 years of experience with chargemaster as required.
2. Experience: Minimum five years of hospital business office experience, or three years of clinical patient care with two years of medical business office experience required. Two years of hospital Medicare billing experience strongly preferred. Experience with interfaces required.

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.

1. Interpersonal Skills Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence. Ability to communicate effectively in writing for policies, procedures, external communications and internal communications. Ability to work effectively with a variety of personnel with varied backgrounds, education and skills, in a team environment. Ability to effectively manage multiple priorities.
2. Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.
3. Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimal; frequent sitting, occasional lifting or moving boxes/supplies, squatting, standing, walking, and occasionally driving a car.
4. Hours of Work: 8 hours per day. Consistent attendance and work at the agreed upon hours of work is required.
5. Compensation: $55.24 - $67.17 Max rate listed is commensurate of 20 plus years of experience in role.

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 https://www.northbay.org/careers/