CDM Analyst

at Christiana Care Health System in Wilmington, Delaware, United States

Job Description

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering exceptional health care. Come join us at ChristianaCare!

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care. ChristianaCare is shaping the future of health care!

ChristianaCare Offers
Full Medical, Dental, Vision, Life Insurance, etc.
Two retirement planning offerings, including 403(b) with company contributions.
Generous paid time off with annual roll-over and opportunities to cash out.
12-week paid parental leave
Incredible Work/Life benefits including annual membership to, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more.

About This Position

Under the direction of the CDM Team Lead, maintains the charge description master (CDM), Financial system CDM creation and charge capture workflows to ensure regulatory compliance and optimal reimbursement in accordance with company policies, and payor contracts. Acts as charge workflow liaison with Information Services, Patient Accounting, Finance, and clinical departments. Maintains demonstrated working knowledge of CPT and HCPCS coding, hospital billing requirements, medical terminology, and charge methodology. Ability to interpret regulatory requirements related to coding and charging. This role will also be responsible for the accuracy of the CDM through assisting with annual CPT/HCPCS code updates, Soarian system upgrades and distribution of data files in part or whole to approved parties.

Principal duties and responsibilities
Responsible for fulfilling CDM request and all the required administrative tasks to achieve timely and accurate recording of gross revenue relative to the maintenance of the CDM.
Identify, replace and update missing, invalid or inaccurate CPT Codes, HCPCs Codes, Revenue Codes in the Charge Description Master.
Perform regular departmental CDM reviews, reviewing quarterly and annual coding changes identifying impacted departments, identifying charge lines with a price below Medicare reimbursement rates.
Develop and maintain a collaborative relationship with clinical department managers and clinicians to ensure the chargemaster contains all billable services performed in the department.
Partner with coders and billers to ensure clinical documentation and coding practices align with the chargemaster to avoid missing charges and revenue leakage.
Provide ongoing and continuous maintenance to ensure all services are accurately charged, the hospital is compliant with government regulations for pricing, and the organization receives accurate reimbursement.
Maintain knowledge of coding guidelines, insurance payer billing and reimbursement rules and CMS regulatory updates to identify CDM, financial system and workflow impacts.
Participate in and assist with operational improvement projects to reduce/eliminate claim denials, coding errors, charge errors and late charges.
Assist in the identification of inaccuracies between what is captured in the order entry, the EHR and the chargemaster.

****Full Job Specification will be provided during the recruitment phase.

Education and experience requirements:

Bachelor's degree from an accredited college in a relevant field of study.

Equivalent and relevant combination of education and experience may be considered in lieu of bachelor's degree.

One to three years hospital Revenue Cycle, Revenue Integrity or Charge Description Master experience preferred.

EEO Statement:

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

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Job Posting: 1243870

Posted On: Feb 26, 2024

Updated On: Mar 19, 2024

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