Charge Description Master Analyst I

Ensemble Health Partners•Work at Home - Ohio - Other, OH

11d•Hybrid

About The Position

The CDM Analyst I analyzes and conducts financial reviews to determine charge capture accuracy and comprehensiveness. Reviews include observance of operational procedures (enhanced business practices), documentation reviews, validation of data entry and final data capture and other aspects of operational audits. Reviews may be conducted with assistance from clinical staff, coordinate with External and Internal Audit and Compliance staff. Ensures accurate establishment of clinical charges, descriptions and billing codes in the charge master. Ensures accurate cross-walk of charge master details with underlying clinical systems used for charge capture and clinical documentation. Ensures compliance with pricing policy. Leads efforts of multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital price master. Leads other multi-disciplinary work groups in revenue enhancement projects including Denial Management and APC Billing committees. Working with groups, also develops new areas of review for future revenue enhancement. Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals. Works with internal and external customers to make key decisions, impacting either the organization as a whole or an individual patient. Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved. Provides guidance to and supports clinical departmental needs on questions, process, status and planned changes or updates to the charge master. Manages communication of routine changes to coding and billing protocols and conventions to affected clinical departments. Accountable for resolving inventory-related edits by reviewing and updating charges as necessary to ensure accuracy and compliance. Assist with implementation of software and providing education to clinical teams on workflow to enhance Chargemaster maintenance workflow.

Requirements

1 to 3 years of previous experience in a similar role
Analyzes and conducts financial reviews to determine charge capture accuracy and comprehensiveness
Reviews include observance of operational procedures (enhanced business practices), documentation reviews, validation of data entry and final data capture and other aspects of operational audits
Reviews may be conducted with assistance from clinical staff, coordinate with External and Internal Audit and Compliance staff
Ensures accurate establishment of clinical charges, descriptions and billing codes in the charge master
Ensures accurate cross-walk of charge master details with underlying clinical systems used for charge capture and clinical documentation
Ensures compliance with pricing policy
Leads efforts of multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital price master
Leads other multi-disciplinary work groups in revenue enhancement projects including Denial Management and APC Billing committees
Working with groups, also develops new areas of review for future revenue enhancement
Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals
Works with internal and external customers to make key decisions, impacting either the organization as a whole or an individual patient
Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved
Provides guidance to and supports clinical departmental needs on questions, process, status and planned changes or updates to the charge master
Manages communication of routine changes to coding and billing protocols and conventions to affected clinical departments
Accountable for resolving inventory-related edits by reviewing and updating charges as necessary to ensure accuracy and compliance
Assist with implementation of software and providing education to clinical teams on workflow to enhance Chargemaster maintenance workflow

Nice To Haves

Experience in the healthcare industry
Charge Master, EAP and coding experience are highly preferred
Experience in physician and hospital operations, compliance and provider relations
Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
CRCR, required within 9 months of hire (company paid)
Epic Certification preferred
AAPC, or similar certification preferred

Responsibilities

Analyzes and conducts financial reviews to determine charge capture accuracy and comprehensiveness
Reviews include observance of operational procedures (enhanced business practices), documentation reviews, validation of data entry and final data capture and other aspects of operational audits
Reviews may be conducted with assistance from clinical staff, coordinate with External and Internal Audit and Compliance staff
Ensures accurate establishment of clinical charges, descriptions and billing codes in the charge master
Ensures accurate cross-walk of charge master details with underlying clinical systems used for charge capture and clinical documentation
Ensures compliance with pricing policy
Leads efforts of multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital price master
Leads other multi-disciplinary work groups in revenue enhancement projects including Denial Management and APC Billing committees
Working with groups, also develops new areas of review for future revenue enhancement
Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals
Works with internal and external customers to make key decisions, impacting either the organization as a whole or an individual patient
Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved
Provides guidance to and supports clinical departmental needs on questions, process, status and planned changes or updates to the charge master
Manages communication of routine changes to coding and billing protocols and conventions to affected clinical departments
Accountable for resolving inventory-related edits by reviewing and updating charges as necessary to ensure accuracy and compliance
Assist with implementation of software and providing education to clinical teams on workflow to enhance Chargemaster maintenance workflow