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Team Lead, Chargemaster Services-Remote (internal)
Chargemaster Analyst-Remote (external)
Duties/Responsibilities:
• Conduct Chargemaster and related reviews for assigned Clients and prepare professional documents outlining summary and detailed findings and recommendations.
• Conduct charge capture reviews for Clients (documentation to charge to bill)
• Conduct NDC to HCPCS validation for Formulary Reviews
• Perform Item Master reviews (vendor catalog number to HCPCS/RC validation)
• Deliver education to Clients in Chargemaster billing, coding, and compliance.
• Prepare written material for client education on various compliance, charging, coding, and billing topics.
• Remain current on all CMS Transmittals and related Federal Register articles for IPPS, OPPS, ASCs, CAHs, and MPFS (and other reimbursement models) and disseminate this information in the form of presentations and seminars to internal and external clients.
• Responsible for building/maintaining charge codes and working with client operational departments.
Required Skills/Qualifications:
• CCS, CCSP, CPC, COC, RHIT, and/or other clinical certification or licensure required (LPN, RN, etc.)
• In the absence of a coding certification or clinical licensure, associate shall agree to complete formal education and training necessary to obtain agreed upon coding certification within 1 year from date of hire.
• CRCR certification from HFMA required or must be obtained within 1 year from date of hire.
• Ability to understand and analyze payor regulations and reimbursement impact to Chargemaster.
• Ability to apply coding guidelines to chargemaster concepts.
• Extensive knowledge of CPT4, HCPCS, UB04 revenue codes, modifiers, billing regulations and APCs.
• Knowledge of clinical settings and operations such as Laboratory, Pharmacy, and/or Radiology.
• Minimum of five years of facility based Chargemaster experience with an additional three years of HIM/billing experience.
• Prior consulting experience preferred.
• Prior experience with Professional-based charging, coding, and billing is preferred.
• Thorough knowledge of Federal, state and payer regulations.
• Capable of interpreting medical records reports.
• Familiarity with claim form content and format (UB04 and 1500)
• Able to work independently and as a team member.
• Capable of applying judgment and decision making
• Intermediate Microsoft Office skills (Word, Excel, PowerPoint, and Outlook).
• Experience managing and reviewing large complex datasets is required. Familiarity with databases and database management tools is preferred.
• Experience in charge building and/or charge dictionary structure in various systems (e.g., Meditech, Cerner, Epic, Siemens, Paragon, Medhost, CPSI, Star, Eagle, etc.)
Prior to Interview all applicants will be required to successfully pass two proficiency assessments. One assessment will cover Chargemaster Essentials and the second will review assess intermediate Excel knowledge.
Abbreviations:
AAPC-American Academy of Professional Coders
AHIMA-American Health Information Management Association
APC-Ambulatory Payment Classification
ASC-Ambulatory Surgery Center
CAH-Critical Access Hospital
CCS-Certified Coding Specialist (AHIMA)
CCSP-Certified Coding Specialist-Physician (AHIMA)
CMS-Centers for Medicare and Medicaid Services
COC-Certified Outpatient Coder (AAPC)
CPC-Certified Professional Coder (AAPC)
CPT-Current Procedural Terminology-4 th Revision
CRCR-Certified Revenue Cycle Representative
HCPCS-Healthcare Common Procedural Coding System
HFMA-Healthcare Financial Management Association
IPPS-Inpatient Prospective Payment System
MPFS-Medicare Physician Fee Schedule
NDC-National Drug Code
OPPS-Outpatient Prospective Payment System
RC-Revenue Code
RHIT-Registered Health Information Technician (AHIMA)
UB04-Uniform Billing Form
Education and/or Experience Associates degree or equivalent from two-year College or technical school or six months to one-year related experience and/or training or equivalent combination of education and experience.
Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
What is in it for you? Well, at Cognizant, we offer a competitive compensation package including excellent benefits such as insurance (available day 1 of employment), great work life balance, 401k with matching component, and many other benefits.
An inclusive environment embracing diversity: for the second time, Cognizant has been named to the Forbes list of Best Employers for Diversity based on survey responses from its employees!
Team Lead, Chargemaster Services-Remote (internal)
Chargemaster Analyst-Remote (external)
Duties/Responsibilities:
• Conduct Chargemaster and related reviews for assigned Clients and prepare professional documents outlining summary and detailed findings and recommendations.
• Conduct charge capture reviews for Clients (documentation to charge to bill)
• Conduct NDC to HCPCS validation for Formulary Reviews
• Perform Item Master reviews (vendor catalog number to HCPCS/RC validation)
• Deliver education to Clients in Chargemaster billing, coding, and compliance.
• Prepare written material for client education on various compliance, charging, coding, and billing topics.
• Remain current on all CMS Transmittals and related Federal Register articles for IPPS, OPPS, ASCs, CAHs, and MPFS (and other reimbursement models) and disseminate this information in the form of presentations and seminars to internal and external clients.
• Responsible for building/maintaining charge codes and working with client operational departments.
Required Skills/Qualifications:
• CCS, CCSP, CPC, COC, RHIT, and/or other clinical certification or licensure required (LPN, RN, etc.)
• In the absence of a coding certification or clinical licensure, associate shall agree to complete formal education and training necessary to obtain agreed upon coding certification within 1 year from date of hire.
• CRCR certification from HFMA required or must be obtained within 1 year from date of hire.
• Ability to understand and analyze payor regulations and reimbursement impact to Chargemaster.
• Ability to apply coding guidelines to chargemaster concepts.
• Extensive knowledge of CPT4, HCPCS, UB04 revenue codes, modifiers, billing regulations and APCs.
• Knowledge of clinical settings and operations such as Laboratory, Pharmacy, and/or Radiology.
• Minimum of five years of facility based Chargemaster experience with an additional three years of HIM/billing experience.
• Prior consulting experience preferred.
• Prior experience with Professional-based charging, coding, and billing is preferred.
• Thorough knowledge of Federal, state and payer regulations.
• Capable of interpreting medical records reports.
• Familiarity with claim form content and format (UB04 and 1500)
• Able to work independently and as a team member.
• Capable of applying judgment and decision making
• Intermediate Microsoft Office skills (Word, Excel, PowerPoint, and Outlook).
• Experience managing and reviewing large complex datasets is required. Familiarity with databases and database management tools is preferred.
• Experience in charge building and/or charge dictionary structure in various systems (e.g., Meditech, Cerner, Epic, Siemens, Paragon, Medhost, CPSI, Star, Eagle, etc.)
Prior to Interview all applicants will be required to successfully pass two proficiency assessments. One assessment will cover Chargemaster Essentials and the second will review assess intermediate Excel knowledge.
Abbreviations:
AAPC-American Academy of Professional Coders
AHIMA-American Health Information Management Association
APC-Ambulatory Payment Classification
ASC-Ambulatory Surgery Center
CAH-Critical Access Hospital
CCS-Certified Coding Specialist (AHIMA)
CCSP-Certified Coding Specialist-Physician (AHIMA)
CMS-Centers for Medicare and Medicaid Services
COC-Certified Outpatient Coder (AAPC)
CPC-Certified Professional Coder (AAPC)
CPT-Current Procedural Terminology-4 th Revision
CRCR-Certified Revenue Cycle Representative
HCPCS-Healthcare Common Procedural Coding System
HFMA-Healthcare Financial Management Association
IPPS-Inpatient Prospective Payment System
MPFS-Medicare Physician Fee Schedule
NDC-National Drug Code
OPPS-Outpatient Prospective Payment System
RC-Revenue Code
RHIT-Registered Health Information Technician (AHIMA)
UB04-Uniform Billing Form
Education and/or Experience Associates degree or equivalent from two-year College or technical school or six months to one-year related experience and/or training or equivalent combination of education and experience.
Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
What is in it for you? Well, at Cognizant, we offer a competitive compensation package including excellent benefits such as insurance (available day 1 of employment), great work life balance, 401k with matching component, and many other benefits.
An inclusive environment embracing diversity: for the second time, Cognizant has been named to the Forbes list of Best Employers for Diversity based on survey responses from its employees!
