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County of Riverside · 1 month ago

Director of Charge Description Master (CDM) & Clinical Auditing - Patient Accounting & Billing Unit

Riverside County, CA

Full-time

Onsite

Lead/Staff, Director/Executive

3+ years exp

The County of Riverside is seeking a Director of Charge Description & Clinical Auditing to join their Patient Accounting and Billing Unit at Riverside University Health System. The role involves managing and optimizing the Charge Description Master (CDM) to ensure compliance with coding rules and billing regulations while collaborating with stakeholders to improve charge capture and accuracy.

GovernmentHealth CarePublic RelationsPublic SafetySocial

No H1B

Responsibilities

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

Develop 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

Qualification

Charge Description Master (CDM)Clinical AuditingEPICMicrosoft ExcelBilingual (English/Spanish)LeadershipCommunicationCollaboration

Required

A Master's degree in Healthcare Administration, Business, or a related field

At least one (1) 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

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

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