Revenue & CDM Optimization Liaison

Trinity Health•Walker, MI

About The Position

The Revenue & CDM Optimization Liaison ensures the integrity of the Charge Description Master (CDM) and charge capture process. The role provides guidance and leadership on procedures charged, CPT codes, billing requirements, and compliance issues; coordinates and implements CDM changes across information systems; and facilitates CDM 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 across the ministry organization to improve revenue collection while meeting local, state, federal, and third-party billing requirements. The liaison performs charge monitoring and follow-up, CDM setup and maintenance, and provides coverage for other departmental functions. The role audits departmental charge masters, reviews coding, departmental and pricing concerns, interviews departments about transaction recording and compliance, reports audit findings, and recommends improvements. It supports charge code and practice implementation, advises on charges for new services and service lines, and provides guidance and education on charge capture, billing, coding, and applicable requirements. The position also prepares analyses and reports, participates in committees and meetings, and liaises with Payer Strategies and System Office CDM and Compliance 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, charge capture activities, or other revenue cycle functions.
Strong knowledge of clinical processes; charge master maintenance; clinical coding (CPT, HCPCS, ICD-9/10, revenue codes, and modifiers); charging processes and audits; and clinical billing.
Working knowledge of Professional Fee Schedule(s) 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 another recognized coding certification is strongly preferred.

Responsibilities

Perform charge monitoring and follow-up, Charge Description Master setup and maintenance, and support coverage of other departmental functions.
Partner with Physicians, Medical Records/Health Information Management, Ancillary, Nursing, Patient Business Service (PBS) center, 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 assess transaction recording and compliance with state and federal charge capture and billing guidelines.
Prepare and report audit findings and recommend actions to management.
Approve and assist with implementing charge codes and charge practices, and provide input and recommendations on charges for new services and service lines.
Analyze financial and other documentation as required.
Provide guidance, communication, and education on charge capture, billing, coding processes, and local, state, and federal guidelines.
Prepare special reports and analyses as directed.
Lead and participate in committees and meetings.
Act as a liaison to Payer Strategies and System Office CDM and Compliance 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.
Work with clinical departments and providers to improve charging processes and revenue collection while complying with billing requirements.