Rev Cycle CDM Coordinator

UPMC

About The Position

The Revenue Cycle CDM Coordinator is primarily responsible for the ongoing control and maintenance of the Charge Description Master Files for all UPMC CBO entities. This individual is responsible for working with Revenue Cycle staff, Finance leadership, and ancillary department heads to ensure all services provided are accurately captured in the Charge Description Master with respect to cost, insurance coding and pricing. This individual is also responsible for maintaining consistency among similar charges across departments and entities.

Requirements

High school diploma or equivalent and 5 years of experience in Business Administration, Finance or Accounting
B.S. degree in related field; Business Administration, Finance, or Accounting preferred
Familiarity with large-scale, automated patient billing systems (e.g. Medipac, SMS), medical terminology and coding (e.g. CPT/HCPCS) preferred.
Behavioral health and pharmacy billing experience is beneficial.
This position requires organization and time management skills.
The incumbent must develop and manage relationships with colleagues in a professional, independent manner.
The position requires the ability to maintain confidentiality with regard to all assignments.
Must possess analytical problem-solving skills as well as the ability to build positive working relationships outside the immediate work group with 3rd party payers, patients or their representatives, physicians, and hospital leadership.
Act 34

Responsibilities

Maintain departmental productivity levels.
Document appropriate account activity in system(s).
Perform all duties and responsibilities according to the philosophy and standards of UPMC, embracing the system-wide core competencies. Adhere to the UPMC and Revenue Cycle Standards of Conduct.
Maintain compliance with quality standards.
Support ancillary information system implementation efforts and other large-scale organizational projects by serving as CDM representative and identifying/analyzing/implementing CDM-related requirements. Provide full cooperation and support to internal and external auditors by providing access to data, policies, or other requested material. Support the design and implementation of new departmental software solutions and related procedures, as appropriate.
Refrain from disclosing or revealing confidential information to any person and do not access patient or coworker records (either electronic or files) except as specifically necessary to perform job duties.
Analyze ancillary departmental charging systems/processes, recommending changes as necessary to ensure timely and accurate revenue capture and billing to third party payers. Effectively support Charge Description Master maintenance activities in a timely manner, including charge additions, CPT/HCPCS code changes, and pricing updates.
Attend all mandatory training as defined in UPMC and Revenue Cycle Policies and Procedures manuals.
Perform daily review/analysis of charging errors, working with ancillary departments to resolve in a timely manner. Effectively manage all assigned BPI worklists in order to meet/exceed established performance metrics. Conduct daily review, analysis, and distribution of high-dollar transaction reports
Work with Revenue Cycle billing staff to identify, analyze and resolve CDM-related claim submission issues. Consistently adhere to the appropriate Quality Assurance procedures in order to maintain the data integrity of the Charge Description Master. Establish and maintain collaborative, customer-focused relationships with all internal departments, as well as all non-hospital groups or entities that interface with the Revenue Cycle.