Chargemaster Specialist
Job Description
Company Description
USPh (U.S. Physical Therapy) is one of the largest publicly traded, independent operators of leading physical and occupational therapy clinics dedicated to enhancing patient outcomes through a collaborative, partnership-driven model. We partner with close to 700 clinics nationwide, across 44 states, offering them the resources, operational support, and clinical expertise needed to thrive in today’s healthcare landscape.
By aligning with the USPh network, our partners benefit from operational support and a shared commitment to evidence-based care, all while maintaining their autonomy and local identity.
We believe that the strength of our partnerships lies in the individuality of each partner. Our “OnePartner” model is designed to allow clinics to maintain their unique culture and identity, empowering them to foster meaningful relationships within their communities. By preserving their local roots, clinics can continue to build trust with patients and referral sources, while attracting top talent who value the chance to be part of a personalized, community-centered environment.
Job Description
The Chargemaster Specialist works with cross-functional teams on projects including but not limited to: review, analyze and maintain chargemaster pricing for all clinics; review payer policies for any updates and changes that may impact reimbursement; provide support to chargemaster team; provide support to payment compliance team by researching claim denial issues and root cause problem solving with payers; help develop standard operating processes.
This Chargemaster Specialist will have the following qualifications: excellent oral and written communication skills; strong interpersonal and relationship-building skills; ability to work both independently and as part of a team with professionals at all levels; certified medical coder; proficient in Microsoft Office software applications. Knowledge of healthcare payer contracts, healthcare billing/payment processes, and experience with outpatient physical therapy, occupational therapy and speech therapy is preferred.
ESSENTIAL FUNCTIONS:
- Maintain and update chargemaster pricing and rationale
- Update Medicare expected reimbursement amounts annually
- Review and update State Workers Compensation and Medicaid expected amounts annually
- Review payer policies for updates and changes that may impact reimbursement
- Research claim denial issues and root cause problem solving with payers
- Special projects
- Support Chargemaster team as needed
- Other duties as assigned
KNOWLEDGE AND SKILLS:
- Excellent oral and written communication skills
- Thorough understanding of managed care claim lifecycle
- Strong interpersonal and relationship-building skills
- Ability to work both independently and as part of a team with professionals at all levels
- Proficient in Microsoft Office software applications including but not limited to: advanced Outlook skills, Excel, Pivot Tables, etc.
- Knowledge of healthcare payer contracts, healthcare billing/payment processes
- Knowledge of physical therapy, occupational therapy and speech therapy is preferred
- Ability to manage multiple projects efficiently and accurately
- Demonstrate ability and commitment to excellent customer service to develop and maintain effective working internal & external relationships
- Able to effectively manage conflicting priorities, adapt to ever changing responsibilities and meet highly structured deadlines
- Excellent critical thinking skills, professionalism, reliable judgment, and the ability to communicate in an articulate and sensitive manner with strategic partners, administrators and internal teams
Qualifications
- Bachelor’s degree in Business, Finance, Health Care, or related field preferred, or high school diploma and appropriate combination of education and experience
- Certified Medical Coder (CPC, CCA, CCS, CCS-P)
- Charge master experience
- 5 years of clinical coding experience in health care setting
Company Information
Location: Houston, Texas, United States
Type: Hybrid