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Revenue Integrity Chargemaster Consultant (Vitalware)

VitalWare

VitalWare

United States · Remote
Posted on Saturday, June 15, 2024

Join one of the nation’s leading and most impactful health care performance improvement companies. Over the years, Health Catalyst has achieved and documented clinical, operational, and financial improvements for many of the nation’s leading healthcare organizations. We are also increasingly serving international markets. Our mission is to be the catalyst for massive, measurable, data-informed healthcare improvement through:

  • Data: integrate data in a flexible, open & scalable platform to power healthcare’s digital transformation​

  • Analytics: deliver analytic applications & services that generate insight on how to measurably improve​

  • Expertise: provide clinical, financial & operational experts who enable & accelerate improvement​

  • Engagement: attract, develop and retain world-class team members by being a best place to work​

Role: Revenue Integrity Chargemaster Consultant

Team: Financial Empowerment / Vitalware

Location: US, Remote

Travel: <40%, US

What you own:

  • Provide consulting services associated with Vitalware’s VitalCDM product
  • Conduct chart reviews to determine lost charges, medical necessity concerns and areas of compliance risk.
  • Initiate, conduct, and complete CDM reviews within the scope of the client contract and utilizing defined Vitalware methodology and tools. Deliver accurate and high-quality recommendations and reports to client. Reports will be exhaustive and provide recommendations and source authority support for the recommendations.
  • Initiate, conduct, and complete CDM standardization and consolidation projects as contractually defined and working within defined project workplan(s); manage completion of project milestones within required timelines. Deliver accurate and high-quality recommendations and reports to client.
  • Provide operational/CDM management consulting services to clients as contractually defined; build positive client relationships through setting client expectations, communicating client requests, and anticipating client needs, thereby encouraging new/repeat business opportunities.
  • Work with Health Catalyst team members to develop project plans defining project scope, timeline, and resources; manage completion of CDM-related project action items within required timelines.
  • Proactively evaluate project activities, identify issues, execute corrective action, and monitor issue resolution to mitigate risks.
  • Maintain issue logs, track issues to resolution, and ensure timely closure of all CDM-related project items, as required.
  • Provide timely updates and status reporting to Client Executives and internal stakeholders as required.
  • Participate with Revenue/Sales team members in pre-contract discovery calls to establish and define client-related CDM requirements.
  • Review, analyze, and interpret VitalCDM exception reports as required and agreed upon; work with client to identify/resolve key issues as outlined in the client contractual agreement.
  • Collaborate with Product Strategy to identify opportunities for improving VitalCDM and/or other current or future products. Collaborate with other team members to identify opportunities for improving departmental performance; contribute to establishing annual strategic and tactical goals.
  • Contribute to the development and presentation of internal and external educational materials.
  • Support other Health Catalyst departments by providing user-perspective input and industry expertise to optimize the client experience.
  • Participate in marketing activities as requested.
  • Participate in continuing education activities to maintain and advance professional skill set.
  • Adhere to company-wide and departmental policies and procedures.
  • Embrace and promote the general concept of good citizenship throughout Health Catalyst.
  • Consistently demonstrate a commitment to Health Catalyst mission, vision and values when carrying out the duties of this position.

Who you are / what you bring:

  • Knowledge of charge capture relating to correct coding and regulatory guidance that will result in an optimal yet compliant chargemaster
  • Knowledge of CMS standards and guidelines.
  • Knowledge of multiple Revenue Cycle/Revenue Management reimbursement systems and processes.
  • Understanding of external and internal drivers affecting revenue management.
  • Knowledge of all aspects of healthcare revenue cycle functions, including registration, coding and documentation standards, charge capture processes, billing and collection processes, as well as government and payer regulations.
  • Practical knowledge of healthcare provider business processes including, but not limited to, any or all of the following: documentation; clinical coding; chargemaster management; charge capture; billing; reimbursement reconciliation; or denials management.
  • Intermediate or advanced proficiency with Microsoft Office applications, e.g., Word, Excel, Access, PowerPoint; ability to perform data analysis functions including combining files, vlookup, MIN, MAX, and AVERAGE
  • Must pass all corporate HIPAA standards and must keep PHI secure and within the confines of the United States borders
  • Proven ability to perform chart (medical record) review to identify chargemaster charge errors, lost charges, overcharges and medical necessity concerns.
  • Ability to perform multiple tasks concurrently in a fast-paced environment.
  • Ability to present ideas effectively in formal and informal situations and convey thoughts clearly and concisely.
  • Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement.
  • Ability to provide leadership and influence others.
  • Above average written communication skills.
  • Above average verbal communication skills.

Recommended Soft & Technical Skills

  • Strong interpersonal, communication, and presentation skills effectively presenting information to clients, executives, management, project teams and/or individuals.
  • Strong customer service orientation.
  • Adapts easily to changing conditions and work responsibilities.
  • Works well with people of vastly differing levels, styles, and preferences.
  • Highly self-motivated.
  • Maintains a positive and results-oriented attitude.
  • Works well independently or as part of a team.
  • Accepts personal responsibility for the quality and timeliness of his/her work.
  • Establishes due dates for projects and assignments; consistently meets those dates by efficiently organizing activities.
  • Exercises sound professional judgment when making decisions and communicating with others.
  • Is reliable, innovative, knowledgeable, tenacious, passionate and respectful.

Preferred Experience & Education

  • Bachelor’s degree or higher; related experience may be considered in lieu of degree.
  • Minimum of three to five years of proven chargemaster consulting experience required. Experience with consulting firm healthcare performance improvement services preferred.
  • Proven review experience of a minimum of 25 chargemasters in a consulting role.
  • Proven ability to interview department stakeholders and provide a positive experience resulting in a coordinated CDM deliverable.
  • Working knowledge of laws and regulations pertaining to healthcare industry required.
  • Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required.
  • Proven track record in CDM management role including experience with charge capture processes, rules and regulations.
  • Previous experience with APC reimbursement and outpatient coding rules, regulations and documentation requirements
  • Proven ability to create exhaustive reports detailing findings, recommendations and source authority documentation supportive of all recommendations.

Information Security and Compliance Responsibilities

  • Maintain compliance with training directives required by the organization pertaining to Information Security, Acceptable Use Policy and HIPAA Privacy and Security.
  • Adhere to and comply with the organizations Acceptable Use Policy.
  • Safeguard information system assets by identifying and reporting potential and actual security events to the organizations Security and Compliance Officers.

The above statements describe the general nature and level of work being performed in this job function. They are not intended to be an exhaustive list of all duties, and indeed additional responsibilities may be assigned by Health Catalyst.

Studies show that candidates from underrepresented groups are less likely to apply for roles if they don’t have 100% of the qualifications shown in the job posting. While each of our roles have core requirements, please thoughtfully consider your skills and experience and decide if you are interested in the position. If you feel you may be a good fit for the role, even if you don’t meet all of the qualifications, we hope you will apply. If you feel you are lacking the core requirements for this position, we encourage you to continue exploring our careers page for other roles for which you may be a better fit.

At Health Catalyst, we appreciate the opportunity to benefit from the diverse backgrounds and experiences of others. Because of our deep commitment to respect every individual, Health Catalyst is an equal opportunity employer.