The Charge Integrity Analyst plays an essential role in Michigan Medicine's Revenue Cycle. Analysts maintain charge and charge-related functionality, provide system and departmental support, and help to ensure the integrity and accuracy of patient accounts.
The core functionality of Charge Integrity is to maintain the hospital and professional charge master and fee schedules. Analysts are expected to remain current on regulatory updates in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee. Analysts work with a large variety of Revenue Cycle and non-Revenue Cycle teams to support charge capture functionality and ensure proper charging practices. Daily tasks include monitoring and working work queues, analyzing charts, addressing charging/process issues and investigating system errors. Projects are assigned to ensure proper build, testing, training, and monitoring of system upgrades and optimizations. Analysts are expected to work closely and promote an atmosphere of teamwork with other members of Charge Integrity as well as their peers in Revenue Cycle, to achieve department objectives and provide stellar customer service.
This position requires strong analytical skills. Analysts must demonstrate the ability to pull and analyze data and documentation, determine root causes, and recommend solutions based on standard coding and billing best practices. Strong excel skills are essential. Knowledge of clinical and hospital workflows, compliance, MiChart, and Epic certifications are beneficial. Analysts must be organized, detail oriented, and work well independently.
- Ensure that the Charge Master is built and maintained in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee standards. Stay current with CMS and other regulatory and payor mandated charge capture guidelines, including revenue code, CPT, HCPCS, and modifier changes.
- Maintain Coding Certification including staying current on articles, newsletters, memos and attend seminars to successfully oversee the Charge Master and ensure its proper use.
- Learn, utilize, and maintain Charge Master data in FinThrive and in the Epic EAP master file.
- Set hospital rates following department policy, using standardized pricing algorithms, available benchmarking and other rate setting tools.
- Work with other Charge Integrity team members and MiChart CORE team as assigned to maintain the following MiChart Files:
- HB and PB Chargeable, Orderable and Performable (EAP)
- Hourly and Daily Bed Charge Billing Table (BCB)
- Cost Center Assignment Table (CCAT) and Cost Center Table (BCC)
- MiChart Rules (Router, Claims Manager, Revenue Guardian, etc.)
- Fee Schedules
- Maintain and support Charge Capture Preference Lists, Bedside Procedure Smartforms, Clinic Performed Orders/Procedures, LOS, Smartsets and other charge capture tools built within the Epic system.
- Learn departmental systems and workflows that interface/support charge capture.
- Maintain files of all critical correspondence, tracking all charge and fee schedule changes.
- Participate in the design, build, and testing of new MiChart and WQ rules that track and identify potential charge errors.
- Assist in developing and establishing new departments (including the build of their charges and charge capture and revenue routing and reconciliation tools).
- Work with Clinical Departments, Revenue Cycle peers, and other MiChart teams to ensure proper charge generation from clinical systems. Provide support as needed to Finance and other Revenue Cycle departments.
- Monitor and work MiChart Workqueues on a timely basis. Communicate to other departments who may need to assist with corrections. Identify areas of improvement.
- Act as liaison between Billing and Clinical Departments to investigate and resolve issues.
- Participate in design, build, test script development, testing, training and go-live support of periodic MiChart Upgrades, new module implementations, system optimizations and other organizational projects.
- Run reports, analyze, and distribute as necessary.
- Patient estimate work as assigned.
- Other projects and ad hoc reports as assigned.
- Associate's degree in Business Administration, Health Administration, Health Information Management, Health Information Technology, Nursing or equivalent combination of education and work experience.
- Experience with facility reimbursement, coding process and compliance concerns related to a charge master.
- Experience as a Certified Coder, Charge Master Administrator, Revenue Integrity Specialist, Epic Analyst or Senior Biller with government payers or e
