Monitoring the hospital Charge Description Master (CDM), ensuring accuracy of the current CDM in addition to performing ongoing financial analytics relating to any changes made to billing, pricing, etc.
Working with various hospital departments to support the organizations' pricing initiatives consistent with the hospital pricing policy.
Collecting data and implements pricing of programs and services consistent with the hospital's pricing policy.
Reviewing financial impact of pricing initiatives and presents impacts to Supervisor.
Completing appropriate processes to develop new charge codes, including obtaining the appropriate signoffs from hospital departments and documenting all new/changed codes.
Communicating changes as necessary and maintain documentation within the department for others to easily access and reference and Tracking and monitoring status of all CDM projects. Performing the monthly reconciliation of hospital Item Master to CDM to ensure that when vendor costs change, charges are revised, if applicable.
Conducting monthly review and reconciliation of supply costs that will result in Quarterly/Annual pricing updates for supplies on the CDM.
Coordinating necessary system changes as a result of new/revised pricing.
Interacting with other hospital departments to facilitate the implementation of changes.
Assisting in modeling financial impacts and determines if estimated impact was achieved.
Compiling financial analytics and models financial impact for mid-year and annual pricing changes.
Providing ad-hoc analyses and ongoing reporting supporting pricing changes.
Assisting in the coordination and production of all changes required for the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) code update.
Identifying and analyzing charge inconsistencies and recommends solutions to Supervisor.
Reviewing CMS quarterly updates to ensure the CDM is compliant with quarterly changes and communicating updates to departments and Patient Financial Services.
Attending educational seminars to stay current on pricing, reimbursement, billing and coding issues.
To qualify you must have.
The knowledge of principles and concepts typically acquired through completion of a Bachelor's degree in Business/Finance, Healthcare or a closely related field and at least 1-2 years of related experience.
Excellent analytical skills to collect information from diverse sources, applying professional principles in performing various analyses, and summarize the information and data for presentation
The following core competencies the ability to take initiative, strong communication and organizational abilities, knowledge of healthcare processes and procedures which includes knowledge of ICD-9, ICD-10, CPT and HCPCS codes preferred.
Solid understanding of hospital operations with third party reimbursement.
The ability to communicate effectively and provide empathy in difficult interpersonal situations, and the ability to work with diverse internal and external constituencies.
Proficiency in MS Office applications, in particular Excel and Access, enterprise systems such as PeopleSoft, and related healthcare systems, experience with Strata is a plus.
BCH offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.
BCH is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.