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Children's Hospital of Philadelphia · 20 hours ago

Charge Description Master Process Analyst

Philadelphia, PA

Full-time

Hybrid

Mid, Senior Level

$74K/yr - $95K/yr

3+ years exp

Children’s Hospital of Philadelphia (CHOP) is dedicated to advancing pediatric care and is seeking a Charge Description Master (CDM) Process Analyst. In this role, you will ensure the accuracy and integrity of the Charge Description Master and physician practice fee schedules, while also collaborating with various departments to manage coding, billing compliance, and revenue cycle issues.

Child CareHealth CareHospitalMedicalNon Profit

Growth Opportunities

Responsibilities

Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs

Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set

Works with the RI Specialist and their revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes

Work with analysts to perform applicable analyses to understand net revenue effect of proposed charge master and fee schedule changes

Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy

Serves as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assists in researching coding issues and recommends solution to account representative. Identifies source of problem and works with analysts to implement corrective actions to ensure that the charge master is updated to prevent future rejections/denials and to ensure accurate and expedient reimbursement

Assist in strategic pricing process to optimize reimbursement within budget guidelines

Participate in ongoing coordination and resolution of revenue issues as they arise

Assists in troubleshooting and resolving issues related to the patient revenue cycle, and assists in development and recommendations

Performs other duties as assigned

Qualification

Healthcare revenue cycleCDM managementBillingCodingRegulatory knowledgeBusiness analyticsResearch skillsCollaborationFacilitation skillsProblem-solvingCommunication skillsDetail-oriented

Required

Associate's Degree Business, Healthcare or related field Required

At least three (3) years Hospital or physician revenue cycle, billing, or coding Required

Business Skills: Knowledge of healthcare revenue cycle functions, and billing and collection processes specific to the charge master. (Required proficiency)

Regulatory: Knowledge of CMS local, state, and federal regulatory and the various data elements associated with all types of claim forms. (Required proficiency)

Business Analytics: Identifies data and analytic challenges including data integrity, appropriateness of data sample, context and consistency between sources. Fully leverages power of analytic tools (Required proficiency)

Collaboration: Experience supporting RI initiatives specific to implementation, and/or major process improvement and redesign. (Required proficiency)

Facilitator: Plans effectively yet is fluid based on the atmosphere and needs of the audience. Connects with the group. Is masterful and an engaging listener. Experience with coding, billing and CDM maintenance (Required proficiency)

Preferred

Bachelor's Degree Business, Healthcare or related field Preferred

At least five (5) years Experience with coding, billing and CDM maintenance Preferred

Certified Outpatient Coder (CPC-H) - American Academy of Professional Coders (AAPC) - within 12 months - Preferred

Company

Children's Hospital of Philadelphia

Glassdoor4.0

Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, The Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine.

Founded in 1855

Philadelphia, Pennsylvania, USA

10001+ employees