Advanced CDM Analyst

DRISCOLL HEALTH PLAN•Corpus Christi, TX

About The Position

This position is responsible for support within hospital revenue integrity operations related to charge capture processes, revenue integrity and charge description master (CDM) oversight. It requires root cause analysis of issues and developing cross-application solution design (system and/or workflow). This position collaborates with the EPIC CDM analyst to implement changes, additions and deletions to the CDM file. The position develops CDM policies and ensures they are compliant.

Requirements

Bachelor's degree (B. A.) from four-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience.

Responsibilities

Maintains utmost level of confidentiality at all times.
Adheres to hospital policies and procedures.
Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
Reviews charges by cost center daily to determine reasonableness and researches any outliers.
Collaborates with the Revenue Integrity Nurse Auditors and the Denials team to establish front end Revenue Guardian checks to improve pre-bill charge accuracy.
Works Revenue Guardian work queue daily, identifies patterns in charge capture opportunities and communicates with departments to identify charge accuracy process improvements.
Reviews and maintains all CDM maintenance activity including data entry.
May coordinate with leaders/team to assist with special projects related to price increases, annual CPT code updates, special requests from clients, system conversions, or implementation of new CDM tools.
May include other duties and/or special projects not listed.
Compile, download, and distribution of statistical CDM information.
Assists with reports and tasks directly related to the chargemaster as assigned.
Performs reconciliation of data input in order to ensure accuracy of CDM.
May assist in training and/or education related to new staff, department staff, and client after experience and competence has been documented.
Other duties as assigned.