Job Posting: Director of Charge Description & Clinical Auditing

The County of Riverside's Patient Accounting and Billing Unit at Riverside University Health System (RUHS) Mission Grove location is seeking a Director of Charge Description & Clinical Auditing to join our team in Riverside.

The Director of Charge Description & Clinical Auditing will be responsible for managing and optimizing the standard Charge Description Master (CDM) to ensure it is accurate and compliant with coding rules and billing regulations. This position will lead the department's efforts in reviewing and researching charge-related data to maintain compliance and accuracy within the system's CDM. The Director will ensure that CDM maintenance requests are processed and completed efficiently, accurately, and in a timely manner.

Additionally, the Director will collaborate with RUHS stakeholders to identify charge-related opportunities, evaluate current procedures, and assess internal controls to ensure charge master code compliance, charge accuracy, and improved charge capture. The role also includes maintaining oversight of the department's documentation of policies and procedures, ensuring compliant billing practices, and educating department staff and other stakeholders on CDM maintenance processes and compliance.

Desired Qualifications:

• A Master's degree in Healthcare Administration, Business, or a related field
• At least one year of hands-on experience with Charge Description Master (CDM) management, including auditing, adding, deleting, updating, cash pricing, and OSHPD reporting.
• Proven experience in clinical audits, including auditing billing charges and handling clinical payer appeals in a hospital environment.
• Clinical experience as an LVN or RN is preferred
• Professional-level experience with EPIC
• Advanced proficiency with Microsoft Excel, including data analysis and report generation.
• Bilingual skills in English and Spanish preferred.

Work Schedule:

9/80 Friday - Day Shift

This position is strictly on-site, with no remote work options. The first 30 days of training will follow a 5/8 schedule.

Meet the Team! Riverside University Health System (RUHS)

The classification for this position is Director of Patient Business Services; however, the working title is Director of Charge Description & Clinical Auditing. This is a continuous posting and will remain up until the position is filled. Applications will be reviewed, and competitive candidates will be referred for interviews in the order in which they are received.

This class has been designated At-Will by the Board of Supervisors, in accordance with the provisions provided under Article 6, Section 601E (8) of the County Management Resolution and serves at the pleasure of the Assistant County Executive Officer-Health System. This class has been deemed eligible for the Performance Recognition Plan as set forth under Article 3, Section 311(C) of the County Management Resolution. Program eligibility requires employees to be in a leadership position, manage other employees or programs, and have significant influence on the achievement of organizational objectives.

Examples of Essential Duties

• Responsible for oversight and management of CDM team.
• Responsible for developing and maintaining the Charge Master standard.
• Ensures that the RUHS system standard Charge Master meets federal, state regulatory requirements and guidelines and adheres to RUHS policies.
• Works with departments to ensure that the Charge Master accurately reflects the services provided by the clinical departments.
• Responsible for periodic reviews of all hospital charges to ensure that all charges are in compliance with RUHS system standard Charge Master.
• Responsible for routinely communicating the status of CDM integrity and accuracy to key stakeholders; notifies stakeholders as appropriate when issues arise.
• Provides reports and other documents as required to measure compliance to the standardized CDM.
• Develops Policies and Procedures for maintaining the RUHS standard CDM incorporating the RUHS CDM Guiding Principles and Charge Policies.
• Evaluates the efficiency or adequacy of Charge Master related processes and leads the development of new procedures as appropriate.
• Builds and maintains effective working relationships with other departments (Epic IS, HIM/Coding, Compliance, Patient Access, Clinical depts. etc.)
• Responsible for implementing routine, standardized reporting to provide stakeholders with commonly requested CDM extracts, Revenue and Usage, etc.
• Serves as Charge master expert for executives and Revenue Cycle pillar leaders; and provides support to CDM team, Revenue Cycle and hospital stakeholders.
• Consults with internal and external customers on the development and implementation of projects and process improvement.
• Maintains communication with all stakeholders to ensure efficient operations and successful implementations; including management of customer satisfaction and expectations.

Minimum Qualifications

Education: Graduation from an accredited college or university with a Bachelor's degree with major coursework in business, public, healthcare, or hospital administration, or other field closely related to patient business services. (Additional qualifying experience may substitute for the required education on the basis of 30 semester or 45 quarter units equaling one year of full-time experience.)

Experience: Three years of supervisory experience, which included responsibility for revenue cycle activities in a hospital or healthcare organization.

Supplemental Information

For questions regarding this recruitment please contact the recruiter, Jill Eastman, at JEastman@rivco.org.

Application Information:

Veteran's Preference: The County has a Veterans Preference Policy applicable to new hires. To qualify, upload a copy of your (or your spouse's) Member-4 Form DD-214 indicating dates of service, and a copy of your spouse's letter of disability (if applicable) with your application. For privacy reasons, it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans' preference. The Veterans Preference Policy, C-3 is available here.

Reasonable Accommodations: The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation, please visit the Disability Access Office web page located at.

Proof of Education: If using education to qualify or when requested by the recruiter, upload a copy of any license(s), official/unofficial transcript(s), degrees, and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.

Work Authorization Requirement: Applicants must be legally authorized to work in the United States at the time of application. The County of Riverside does not participate in visa sponsorship programs, including H1-B visas, and will not provide sponsorship for any employment-based visas.

Equal Opportunity Employer: The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition (cancer and genetic characteristics), genetic information, or denial of medical and family care leave, or any other non-job-related factors.

Pre-Employment: All employment offers are contingent upon successful completion of pre-employment requirements including a criminal background investigation, which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A pre-employment physical examination and background check may be required.

Probationary Period: As an Approved Local Merit System, all County of Riverside employees, except those serving "At Will," are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding, County Resolution, or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.

General Information: Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.

Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume, as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.

Please read and follow any special application instructions on this posting. Click the 'Apply' link located on this page to submit your application. For additional instructions on the application process, examinations, Veteran's preference, pre-employment accommodation or other employment questions, please refer to our web site.