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The University of Kansas Health System · 2 months ago

Charge Description Master (CDM) Analyst (Remote Opportunity)

United States

Full-time

Remote

Mid Level

3+ years exp

The University of Kansas Health System is seeking a Charge Description Master (CDM) Analyst. This role is responsible for maintaining and optimizing the hospital's Charge Description Master to ensure accurate, compliant, and efficient billing processes while collaborating with various teams to analyze financial impacts and ensure compliance with regulatory standards.

Clinical TrialsEducationEmergency MedicineHealth Care

Growth Opportunities

Responsibilities

Maintains all inpatient, outpatient and physician charge description documents to ensure that all items are a direct reflection of chargeable and billable services; initiates, coordinates, monitors, reviews, analyzes and implements requests to add, change or delete CDM items as appropriate; improves efficiency by eliminating duplicate, inactive or non-compliant charges, thus decreasing the potential for an inappropriate charge being utilized

Research billing guidelines to maintain CDM compliance with Medicare and Medicaid standards; reviews and updates documents concerning procedural and coding changes and initiates action to update the hospital charge description master as necessary; performs data quality reviews on individual department charge descriptions to ensure compliance with all payer mandates and reporting requirements

Performs CDM quality control and troubleshooting activities; performs systematic reviews of system-generated reports to monitor charging practices and identifies potential problems; recommends workflow and other process changes to address charging problems or deficiencies; audits health care provider progress notes to ensure that appropriate charges are being reported on patient billing documents; researches and resolves complex billing issues involving rejected charges; analyzes file data for evidence of deficiencies in controls, duplication, fraud, process breakdowns, or compliance

Maintains and/or modifies departmental charge documents to reflect current CDM choices

Research industry trends regarding pricing policies and recommends adjustments to pricing strategies and policies; confers with Hospital management to analyze CDM billing processes, to identify root causes of denials/underpayments, and to analyze new third-party payment requirements

Implements CDM data entry or upload maintenance requests; works with information systems staff to ensure that the appropriate CDM information is properly loaded and placed on the claims

Coordinates and/or oversees projects and processes as assigned; prepares reports, studies, analyses, and other documents as assigned; presents findings to individuals and/or groups as required

Performs other duties as assigned

Works effectively with Revenue Integrity Clinical Nurse Auditor, CDM, and Pricing Committees

Demonstrates knowledge of Coding Guidelines and Conventions (CPT/HCPCS, ICD-10-CM/PCS)

Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department

Qualification

Charge Description MasterMedical billingCodingCPT/HCPCS codingEpic trainingCertified Charge Capture ProfessionalCertified Public AccountantBusiness administrationFinanceRevenue integrity

Required

Bachelors Degree in business administration, finance, or a related field of study from an accredited college or university

3 or more years of experience in a charge description master or revenue integrity related position that provided broad based knowledge of hospital financial operations including reimbursement

Designated Epic training to be completed within 6 months of hire