Liberty Hospital is seeking a Charge Description Master Analyst to manage the integrity and accuracy of our hospital's billing data. You will be responsible for maintaining and optimizing the Charge Description Master to ensure compliant, efficient, and accurate billing processes across inpatient, outpatient, and physician services.
What You'll Do
- Maintain all inpatient, outpatient, and physician charge description documents to ensure items reflect chargeable and billable services.
- Initiate, coordinate, and implement requests to add, change, or delete CDM items as appropriate.
- Improve efficiency by eliminating duplicate, inactive, or non-compliant charges.
- Research billing guidelines to maintain CDM compliance with Medicare and Medicaid standards.
- Perform data quality reviews on departmental charge descriptions to ensure compliance with all payer mandates.
- Perform CDM quality control, troubleshooting, and systematic reviews of system-generated reports to monitor charging practices.
- Recommend workflow and process changes to address charging problems or deficiencies.
- Audit healthcare provider progress notes to ensure appropriate charges are reported on patient billing documents.
- Research and resolve complex billing issues involving rejected charges.
- Analyze file data for evidence of deficiencies in controls, duplication, fraud, process breakdowns, or compliance issues.
- Research industry trends regarding pricing policies and recommend adjustments to pricing strategies.
- Confer with hospital management to analyze CDM billing processes, identify root causes of denials, and analyze new third-party payment requirements.
- Implement CDM data entry or upload maintenance requests.
- Work with information systems staff to ensure appropriate CDM information is properly loaded and placed on claims.
- Coordinate or oversee projects and processes as assigned.
- Prepare reports and present findings to individuals or groups as required.
- Demonstrate knowledge of Coding Guidelines and Conventions (CPT/HCPCS, ICD-10-CM/PCS).
What We're Looking For
- Bachelor's Degree in business administration, finance, or a related field from an accredited college or university.
- 3 or more years of experience in a charge description master or revenue integrity role with broad knowledge of hospital financial operations and reimbursement.
- Ability to complete designated Epic training within 6 months of hire.
Nice to Have
- Master's Degree in Business Administration, Finance, or a related field from an accredited college or university.
- 5 or more years of experience with medical billing and coding and/or CPC or CPC-A coding certification.
- Certified Public Accountant (CPA) credential from a State Board of Accountancy.
- Certified Charge Capture Professional (CCCP) credential from AAPC/HFMA.
Team & Environment
You will work effectively with the Revenue Integrity Clinical Nurse Auditor, CDM Committee, and Pricing Committees.
Work Mode
This is a fully remote position.
Liberty Hospital is an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status, or genetic information.
