Revenue & CDM Optimization Liaison

Trinity Health•River Ridge, GA

About The Position

The Revenue & CDM Optimization Liaison ensures the integrity of the Charge Description Master (CDM) and charge capture processes by providing guidance and leadership on procedures, CPT codes, billing requirements, and compliance. The role coordinates and implements CDM changes across information systems and facilitates requests with the System Office CDM and Compliance team. It ensures CDM codes comply with Medicare and local payer guidelines and works with clinical departments and providers throughout the ministry organization to improve charging processes and revenue collection while meeting local, state, federal, and third-party billing requirements. The position performs charge monitoring and follow-up, CDM setup and maintenance, and supports other departmental functions. It partners with Physicians, Medical Records/Health Information Management, Ancillary, Nursing, Patient Business Service (PBS), Information Services, Compliance, and Managed Care staff. It also prepares reports and analyses, participates in committees and meetings, and liaises with Payer Strategies and the System Office CDM and Compliance teams to understand local contracts and maintain CDM alignment.

Requirements

Bachelor’s degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of education and experience.
Five years of experience in billing, charge documentation, charge audit or charge capture activities, or other revenue cycle-related functions.
Strong knowledge of clinical processes; charge master maintenance; clinical coding, including CPT, HCPCS, ICD-9/10, revenue codes, and modifiers; charging processes and audits; and clinical billing.
Working knowledge of Professional Fee Schedules from CMS, local Medicaid, and other commercial payers.
Knowledge of third-party payer rules and requirements, computer operations, and electronic interfaces related to charge documentation, capture, and billing.
Excellent interpersonal, verbal, written communication, and organizational skills.
Accuracy, strong analytical skills, attention to detail, and time management skills.

Nice To Haves

Certified Professional Coder (CPC), CCS, or other recognized coding certification is strongly preferred.

Responsibilities

Monitor charges, follow up on charge issues, maintain the Charge Description Master (CDM), and support coverage of other departmental functions.
Partner with Physicians, Medical Records/Health Information Management, Ancillary, Nursing, Patient Business Service (PBS), Information Services, Compliance, and Managed Care staff.
Regularly audit each department’s Charge Master, reviewing coding, departmental and pricing concerns, and other appropriate issues.
Conduct departmental interviews to verify transaction recording and compliance with state and federal charge capture and billing guidelines.
Prepare and report audit findings and make recommendations to management.
Approve and assist with implementing charge codes and charge practices; provide input and recommendations on charges for new services and service lines.
Analyze financial and other documentation as needed.
Provide guidance, communication, and education on correct charge capture, billing, and coding processes and applicable local, state, and federal guidelines.
Prepare special reports and analyses as directed.
Lead and participate in committees and meetings.
Liaise with Payer Strategies and the System Office CDM and Compliance teams to understand local contracts and ensure CDM alignment.
Coordinate and implement CDM changes in information systems and facilitate CDM requests with the System Office CDM and Compliance team.
Ensure CDM codes comply with Medicare and local payer guidelines.
Work with clinical departments and providers to improve charging processes and revenue collection while maintaining compliance with billing requirements.