Participates with the development, implementation and maintenance of the Enterprise hospital/healthcare Charge Description Masters (CDMs) which includes reviewing, updating, auditing, and charge capturing in clinical and financial systems for standardization of procedures, code assignments, in accordance with regulatory, DHS policies and procedures, and adherence to changes/updates required by Clinical Management Systems (CMS) or other agencies.
 
Participates in analyzing charge capture workflows, preparing audit findings and recommendations to management. Make CDM-related decisions based on significant analysis and investigation recommending solutions/corrective action of non-compliance, and assists in implementation of those recommendations, where appropriate.
 
Assists in the CDM processes, analyzing charging mechanisms, audits clinical and financial systems, etc. to ensure the appropriate business and/or system for designs, resolve charge capture problems, ensure appropriate business and/or systems of the Enterprise Electronic Health Record (EHR) aka ORCHID, ORCHID sub-systems such as Merge, Endoworks, and Patient Accounting systems. ORCHID systems includes but not limited to Laboratory, Radiology, Ambulatory, FirstNet (Emergency Department) SurgiNet (Surgery), PharmNet (Pharmacy), Infusion Billing, Behavioral Health, Item Master (Supplies) Nursing Clinical Documentation, code sets, etc., as well as, maintain the Enterprise Charge Description Masters according to industry changes and new/existing rules and regulations for both ORCHID, Affinity Patient Accounting and Enterprise Patient Data Repository (EPDR).
 
Participates in ensuring all services rendered by DHS is captured, by analyzing workflows for charge capture have been identified and set-up correctly in the Enterprise
EHR CDM. 
 
Participates in ensuring accurate charge capturing to optimize coding and reimbursement for DHS.
 
Analyze, interpret, and review State and Federal regulations.
 
Analyze clinical and financial data such as, charge data and other clinical data utilizing various software tools such as, Microsoft Excel, Access, Cerner Power Insight, etc. to develop and/or extract data for creating reports, etc.
 
Participates in the maintaining the CDM by incorporating new charges/services identified by the departments, third party changes, regulatory requirements and coding updates. Identify services that are reimbursable, but are not being coded; review, assign and validate revenue codes. Examine, report and make recommendations regarding departmental charge activities for compliance with DHS policies and strategic directives. Maintain timely turnaround of all Charge Master requests from facilities and other DHS departments.
 
Participates in maintaining the Charge Master through on-going review of current service code data as well as entry data for new and revised charge items as requested by DHS facilities. Enter change for like-items for standardization, accuracy, and compliance. Identify and resolve charge capture discrepancies, charge inconsistencies, claim issues and other potential problem areas. Identify revenue enhancement opportunities.
 
Participates and assists in maintaining CDM and revenue integrity by analyzing and reconciling information retrieved from available data including daily error reports, Charge Master activity reports, volume reports, etc. Evaluate the changing structure and streamlines the charge process by the elimination of duplicate, inactive or non-compliant charges.
 
Participates and assists in a detailed, annual review of the CDM, which includes identifying Current Procedural Terminology (CPT) and Health Common Procedure Coding System (HCPCS) specific codes when appropriate; identify description changes and ensure the nomenclature reflects the procedures performed; assist in maintaining the Charge Master by ascertaining that charge codes, procedure codes (CPT, HCPCS), revenue codes and relative value units are consistent with clinical practices and are in accordance with billing criteria and third party payor and/or other regulatory mandates.
 
Knowledge and experience using a Charge Master Management System. Utilizes the Change Request functions in the Charge Master Management System (CMMS) to document, track EHR additions, deletions and changes for the ORCHID and Patient Accounting Systems CDMs.

Participates in special reviews for management, such as those required to identify mechanics of detected fraud and to develop controls for fraud prevention. Participates in the investigation of complex fraud-related issues (i.e., bundling and unbundling), as necessary.

Participates in the collaborations with Information Systems (IS) and other departments to ensure that the appropriate CDM reimbursement data is captured and reported correctly; this includes ancillary or clinical systems related to the revenue cycle, charge capture, cost reporting and billing to identify and facilitate the implementation of changes that impact the CDM.
 
Troubleshoot and resolve issues related to the charge capturing, CDM issues, patient revenue cycle, develop and present recommendations. Research and resolve CPT and HCPCS codes, revenue codes, relative value units and other issues. Perform post-audit of accounts billed by outside agencies to ensure optimum reimbursement. This may include review of medical records to ensure all procedures are captured and billed appropriately.
 
Serve as a resource to hospital departments, i.e.; assist with the start-up process for new CDM-related programs, answer implementation questions, etc.

Participates and assists in assessing the accuracy of charge capture workflows, forms, charge screens, online screens and other charging vehicles. Analyze data and identify deficiencies in controls, duplication of effort, fraud, or lack of compliance with laws and government regulations; utilize data gathered to assist in development of CDM management policies and procedures.
 
Distribute correspondence of regulatory requirements changes to departments for review of impending revisions. Review, interpret, and analyze billing publications, third party billing manuals, regulatory (i.e., CMS) publications and newsletters to ensure CPT, Relative Value Units (RVUs), Universal Billing Revenue Code (UB04) (revenue codes) etc., are in compliance with mandates, regulations, guidelines and procedures.

Attends conferences, workshops, seminars, etc. to maintain a high level of knowledge and capabilities.

SELECTION REQUIREMENTS:

Three (3) years of experience in a staff capacity* analyzing and making recommendations for the solution of problems of organization, program, procedure, budget or personnel. One (1) year of which must include responsible experience in Charge Services maintaining a Charge Description Master (CDM). Such experience must include reviewing, updating, auditing, and charge capturing in clinical and financial systems for standardization of procedures, code assignments, regulatory compliance, and adherence to changes/updates required by Clinical Management Systems (CMS) or other agencies.

LICENSE:
A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.

PHYSICAL CLASS: 2 - Light.
Light: Light physical effort which may include occasional light lifting to a 10 pound limit, and some bending, stooping or squatting. Considerable walking may be involved.

DESIRABLE QUALIFICATIONS:
Credit will be given to applicants who possess the following desirable qualifications:

• Any additional experience in excess of the selection requirements.
• Experience participating in developing, implementing, projects, business processes, etc. involving the CDM and related interfaces.
• Experience developing, implementing, and maintaining a Quality Audit Program for a CDM.
• Experience involving International Classification of Diseases 9th or 10th CM (ICD-9, ICD-10 CM) in relationship to maintaining an enterprise or hospital CDM and interfaces.
• Course work from an accredited college or university** in Medical Terminology, Current Procedural Terminology (CPT), Health Common Procedure Coding System (HCPCS), or Universal Billing Revenue Code (UB04).
• Certification as a Registered Health Information Administrator (RHIA)***, Registered Health Information Technician (RHIT)***, Certified Coding Specialist (CCS)***, or Certified Coding Specialist-Physician Based (CCS-P)*** by American Health Information Management Association (AHIMA)****.

EXAMINATION CONTENT:
This examination will consist of an evaluation of training, knowledge and experience in the relevant technical field, and desirable qualifications based on your application information and supplemental questionnaire weighted 100%.

Candidates must achieve a passing score of 70% or higher on this examination in order to be added to the eligible register.

ELIGIBILITY INFORMATION:
Applications will be processed on an "as-received" basis and those receiving a passing score will be promulgated to the eligible register accordingly.

The names of candidates receiving a passing score in the examination will be added to the eligible register in the order of their score group for a period of twelve (12) months following the date of promulgation.

No person may compete in this examination more than once every twelve (12) months.

SPECIAL INFORMATION:
Appointees may be required to work any shift, including evenings, nights, weekends, and holidays.

The County of Los Angeles is a Fair Chance employer. Except for a very limited number of positions, you will not be asked to provide information about a conviction history unless you receive a contingent offer of employment. The County will make an individualized assessment of whether your conviction history has a direct or adverse relationship with the specific duties of the job, and consider potential mitigating factors, including, but not limited to, evidence and extent of rehabilitation, recency of the offense(s), and age at the time of the offense(s). If asked to provide information about a conviction history, any convictions or court records which are exempted by a valid court order do not have to be disclosed.

VACANCY INFORMATION:
The resulting eligible register for this examination will be used to fill vacancies at the Department of Health Services (DHS) Enterprise Data & Information Management (EDIM) Charge Services Applications, Support Division located at 12021 S. Wilmington Avenue, Los Angeles CA 90059.

APPLICATION AND FILING INFORMATION:

Applications must be filed online only. Hardcopy / paper applications submitted by U.S. MAIL, FAX, OR IN PERSON will not be accepted.

Applications electronically received after 5:00 p.m., PT, on the last day of filing will not be accepted.

Apply online by clicking on the green "APPLY" button at the top right of this posting. You can also track the status of your application using this website.

The acceptance of your application depends on whether you have clearly shown that you meet the REQUIREMENTS. Fill out your application completely and correctly to receive full credit for relevant education, training, and experience in the spaces provided so we can evaluate your qualifications for the position.  Do not group your experience. For each position held, give the name and address of your employer, your position title, beginning and ending dates, number of hours worked per week, and description of work performed. If your application is incomplete, it will be rejected.

IMPORTANT NOTES:

• All information and documentation provided by applicants is subject to verification.
• We may reject your application at any time during the examination and hiring process, including after appointment has been made.
• Falsification of any information may result in disqualification or rescission of appointment.  
• Utilizing verbiage from Class Specification and/or Minimum/Selection Requirements serving as your description of duties will not be sufficient to demonstrate that you meet the requirements. Comments such as "See Resume" or referencing other unsolicited materials/documents will not be considered as a response; in doing so, your application will be rejected.