Ensemble Health Partners · 5 hours ago

Analyst, CDM I

United States

Full-time

Remote

Mid, Senior Level

$52K/yr - $99K/yr

6+ years exp

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Responsibilities

Reviews include observance of operational procedures (enhanced business practices), documentation reviews, validation of data entry and final data capture and other aspects of operational audits. Reviews may be conducted with assistance from clinical staff, coordinate with External and Internal Audit and Compliance staff.

Ensures accurate establishment of clinical charges, descriptions and billing codes in the charge master.

Ensures accurate cross-walk of charge master details with underlying clinical systems used for charge capture and clinical documentation.

Ensures compliance with pricing policy.

Leads efforts of multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital price master.

Leads other multi-disciplinary work groups in revenue enhancement projects including Denial Management and APC Billing committees.

Working with groups, also develops new areas of review for future revenue enhancement. Groups may include representatives from various clinical areas, Coding, Medical Records, Billing, Compliance and Information Systems. Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals.

Works with internal and external customers to make key decisions, impacting either the organization as a whole or an individual patient.

Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved.

Provides guidance to and supports clinical departmental needs on questions, process, status and planned changes or updates to the charge master. Manages communication of routine changes to coding and billing protocols and conventions to affected clinical departments.

Performs other duties as assigned.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Charge MasterCodingCRCR certificationHealthcare industry experiencePatient access certificationPatient accounting certificationComplianceData analysisRevenue cycle managementFinancial reviewOperational auditsPerformance data interpretation