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Charge Description Master Analyst

Summary:

Responsible for the oversight of Charge Description Master (CDM) functions and reimbursement analysis within the revenue management department. This position will serve as a member of the revenue management team and subscribe to the vision, values and expectations.​

Responsible for the supervision and coordination of Chargemaster management functions in researching coding and billing guidelines, researching insurance contracts, and updating hospital Chargemaster.

Duties:

  • Works with the revenue producing departments to ensure the ongoing coordinated consistency of the Chargemaster, including accurate descriptions, coding, additions, deletions, pricing, and any other changes.
  • Collaborate with managerial and supervisory staff to ensure regulatory billing with correct coding on accounts.
  • Maintain a working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the health system in cash collection while accurately complying with billing guidelines. Monitor compliance with corporate, federal, and state guidelines.
  • Maintain timely turnaround of all Chargemaster requests.
  • Participate in ongoing coordination and resolution of revenue issues as they arise.
  • Work with Finance to perform applicable analyses to understand net revenue effect of proposed Chargemaster changes.
  • Monitor facility charging mechanisms and systems.
  • Performs analysis, identifies trends, validation of compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs and overall expense reduction.
  • Analyze reports to determine areas of improvement and determine appropriate plan of action.
  • Disseminate CMS updates to health care providers as they relate to billing for drugs, implantable and/or other pass-through eligible items, ensuring the necessary changes are made to the entity specific Chargemaster files within the time frame for accurate and compliant billing.
  • Troubleshoot and resolve issues related to the patient revenue cycle,develop and present recommendations.
  • Remain current with updated coding and billing regulations.
  • Develop and maintain strong working relationships with internal and external customers.
  • Maintain high productivity and quality with minimal supervision. Yearly continuing education is required.

Education and Experience:

  • A Bachelor's degree in business, healthcare administration or a related field is required.
  • 4+ years of related experience is required.
  • Coding certification is strongly preferred
  • Ability to understand and analyze payor regulations and the impact to the Chargemaster on reimbursement and coding guidelines.
  • Ability to multi-task and work under aggressive deadlines. Possess effective time management skills to permit handling of a large workload.
  • Extensive knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers,billing regulations and APCs.
  • Must have a good understanding of the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget.
  • Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
  • Ability to research complex coding and regulatory requirements.
  • Strong analytical skills.

 

 

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