Start the day excited to make a difference...end the day knowing you did. Come join our team.
The CDM Analyst maintains the Charge Description Master (CDM), helps develop and ensure compliant and effective charge policies, and works closely with the clinical and revenue cycle teams to ensure proper revenue capture. The incumbent will monitor regulatory changes and assist with implementation; as well as assist with reporting and auditing of charges to improve the performance of the charge process.
***Can only accept applicants from the following states: VA, NC, SC, GA, FL, NE, TX, WV, and WI***
Essential Functions & Responsibilities:
Oversees CDM maintenance including overseeing annual updates, reviewing and approving all changes, and working with clinical areas to ensure the accuracy of their CDMs.
Reviews prices annually to ensure competitive and compliant pricing.
Assists with the development of charge policies and ensures compliance.
Helps develop, coordinate, and monitor on-going internal charge capture and charge reconciliation processes and quarterly audits for clinical areas.
Assists and guides departments with the charge reconciliation process.
Supports the clinical and revenue cycle teams in resolving issues related to charging and CDM setup; billing, edits, denials, etc; to ensure proper payment.
Identifies revenue opportunity, facilitates change, and improves process through collaboration with both revenue cycle and clinical teams throughout the organization.
Implements improvements to charge processes to reduce late charges, errors, missed charges, or inconsistent charge practices.
Works with clinical areas to create new CDMs and charge processes for new and modified services.
Keeps current with all governmental regulations and commercial requirements related to the CDM and charging.
Works with various departments and clinical service areas to maintain compliance with relevant regulations, standards and directives from regulatory agencies and third-party payors.
Performs audits of bills to ensure compliance with charging, coding, regulatory or contractual requirements.
Provides education and/or process improvement to departments as part of the root cause analysis resolution.
Performs other duties as assigned.
Bachelor's Degree required. Three (3) years progressive experience in healthcare revenue cycle required.
Knowledge of general hospital billing processes, medical terminology and coding guides required.
Knowledge of CPT, HCPCS, Revenue Codes, and compliance required; CPC certification preferred.
Prior experience with Microsoft Excel and Word, Epic, 3M, nThrive and/or ICD-10 preferred.
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
A Not-for-Profit Regional Healthcare System Dedicated to Excellence. From our humble beginnings in Fredericksburg, Virginia as an eight-room hospital to our modern not-for-profit regional system, Mary Washington Healthcare has seen enormous growth and development in the past 100 years. Today, we are made up of two hospitals and 28 healthcare facilities and wellness services. Community leaders volunteer on our Board of Trustees in order to guide the continued growth and direction of our health care system.