CDM Analyst

Summary

• Position Summary
  • The Charge Description Master (CDM) Analyst is responsible for processing charge master changes, requests for new services, deletions, and updates in the Meditech charge description master for patient chargeable items/service for both ambulatory and hospital clinical departments.  The CDM Analyst is responsible for advising and ensuring proper charging, billing and coding practices relative to charge capture for services.  Is a resource within revenue cycle operations and to clinical departments for charge master, billing and claims presentation requirements.  Collaborates with Pharmacy and Laboratory leadership on CDM updates for those clinical areas.
• Education
  • Bachelors of Healthcare - Preferred
  • Medical terminology  - Required
  • Courses in computer technology, medical coding, medical billing, and project management – Preferred
• Experience
  • 2 or more years hospital or physician revenue cycle - Required
  • Experience with CPT/HCPCS coding, medical billing, claims processing, and/or other related healthcare revenue cycle roles/processes - Required
  • Experience using Microsoft Excel and Office products - Required
  • Experience with hospital or physician charge description or related dictionaries - Preferred
• License & Certification
  • Professional Certification such as Registered Health Information Technician (RHIT), Certified Professional or Outpatient Coder (CPC or COC) or Certified Revenue Cycle Specialist (CRCS) or similar certification  – Required or obtained within one year of hire date
• Core Job Functions
  • Processes charge description master changes including updates, additions and deletions in both Live and TEST environments of Meditech. 
  • Accurately reviews charges and revenue daily for correct coding and makes changes as necessary. Serves as back-up resource for claims clearinghouse edits assigned to the Revenue Integrity department. Remains up to date with the various Federal and commercial insurance companies’ claim filing, billing and coding regulations and guidance. 
  • Monitors charge updates in Trisus/Craneware and ensures charge requests are completed timely.  Collaborates with Pharmacy, Ambulatory departments, and Laboratory designees to ensure timely and accurate inputs in the chargemaster for these clinical areas.
  • Assists the Revenue Integrity Director and Sr. Revenue Integrity Analyst in an annual review of the Chargemaster to include all data elements including pricing updates. Correctly inputs charges under the guidance of the Revenue Integrity Director or designee.
  • Assists with monitoring of the clinical staff responsible for charge capture, charge reconciliation and monitoring of late charges. Collaborates with Pharmacy, Laboratory, and Materials Management to ensure timely updates to CDM items for these high volume areas.
  • Reviews charge rejection reports and corresponding clinical documentation to ensure that charges are accurate; communicates the corrections needed to the appropriate clinical department. Ensures that charge rejections and corrections are made in a timely manner.