What are the responsibilities and job description for the Chargemaster Specialist position at Coding Concepts?
Benefits:
Coding Concepts is seeking an experienced Chargemaster Specialist with extensive knowledge of hospital and professional billing, coding regulations, and revenue cycle processes. This role is vital in ensuring accurate and compliant charge capture, billing practices, and optimization of revenue through the development and maintenance of the hospital chargemaster (CDM). The ideal candidate is a highly skilled professional who understands the complexities of healthcare finance, coding guidelines, and the critical role the chargemaster plays in operational and financial performance.
Role Responsibilities
▫ CMS regulations and billing guidelines
▫ UB-04 and CMS 1500 billing processes
▫ Medicare and commercial payer reimbursement methodologies (OPPS, IPPS, fee schedules)
This is a remote position.
- Flexible schedule
Coding Concepts is seeking an experienced Chargemaster Specialist with extensive knowledge of hospital and professional billing, coding regulations, and revenue cycle processes. This role is vital in ensuring accurate and compliant charge capture, billing practices, and optimization of revenue through the development and maintenance of the hospital chargemaster (CDM). The ideal candidate is a highly skilled professional who understands the complexities of healthcare finance, coding guidelines, and the critical role the chargemaster plays in operational and financial performance.
Role Responsibilities
- Maintain and update the chargemaster (CDM) to ensure accuracy, compliance, and alignment with coding, billing, and reimbursement requirements.
- Collaborate with clinical, coding, billing, compliance, and IT teams to ensure charges are appropriately assigned and reflect current services provided.
- Analyze and interpret regulatory changes (CMS, AMA, etc.) and apply them to CDM updates.
- Conduct audits and reviews of charge capture processes and recommend improvements.
- Identify revenue leakage and undercharging through routine reviews of high-volume and high-cost departments.
- Assist in pricing strategies and conduct market analysis for competitive rate structures.
- Support implementation of new services, supplies, or procedures with appropriate coding and charge setup.
- Work closely with finance and reimbursement teams to support cost reporting and payer compliance.
- Bachelor’s degree in Health Information Management, Finance, Healthcare Administration, or a related field preferred.
- Certification Required: CCS, RHIT, RHIA, or CPC for at least 3 years.
- Experience working in a rural healthcare facility or a critical access hospital.
- Familiarity with billing software, CDM maintenance tools, and electronic health records (EHRs).
- Minimum of 3–5 years of hands-on experience working with the hospital chargemaster/CDM.
- Expert knowledge of:
▫ CMS regulations and billing guidelines
▫ UB-04 and CMS 1500 billing processes
▫ Medicare and commercial payer reimbursement methodologies (OPPS, IPPS, fee schedules)
This is a remote position.