Minimum Education: High school diploma or GED. Bachelor’s degree in Business, Finance, Healthcare Administration, or related field, preferred.
Licensure, Registration and/or Certification: None. Certified Revenue Cycle Representative (CRCR) from the Healthcare Financial Management Association (HFMA), preferred. Epic Certifications (Resolute Hospital Billing, Resolute Professional Billing, Revenue Integrity), preferred.
Work Experience: Minimum 5 years of Billing, Charge Capture, Charge Description Master (CDM) Management, Revenue Cycle Analytics, or Revenue Integrity within Healthcare experience.
Knowledge, Skills, and Abilities: Advanced knowledge of charge capture processes, charge router logic, charging methodologies, and clinical workflows. Advanced knowledge of healthcare coding systems (Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding Systems (HCPCS), International Classification of Diseases (ICD-10)), and reimbursement methodologies. Strong understanding of Epic workflows, including charge router, charge review, work queues, and Charge Description Master (CDM) integration. Strong data analysis capabilities, including with large datasets, financial modeling, and root-cause analysis. Knowledge of healthcare regulatory requirements and revenue cycle operations. Strong leadership and collaboration skills. Excellent communication skills, both written and verbal that present clear and concise information. Effective organizational skills and attention to detail. Ability to educate and mentor staff, influence decision-makers, and communicate technical concepts to non-technical audiences. Ability to independently manage complex projects, timelines, and cross-functional deliverables.