The Senior System Charge Description Master (CDM) Analyst will be responsible for ensuring accurate patient billing according to governmental policies and CHRISTUS compliance and integrity policies for the enterprise. Functions as primary adjudicator of all charge master requests. This will include researching alternative procedures, software and equipment designed to improve operational effectiveness through comparison to comprehensive AMA/CPT and HCPCS service, drug, supply item grids as potential billable services. Provides charge description master expertise and advice related to charge description master management with the goals of attaining reimbursement accuracy, reducing denials, and maintaining regulatory compliance. The Senior Charge Description Master Analyst is an internal subject expert who will be responsible for the complete CDM maintenance process for all regions including on-going updates and revisions, incorporation of code set corrections, revenue code to CPT/HCPCS code mismatch corrections and newly identified charges for current systems and future standards developed. Auditing of charging procedures and revenue capture projects will be performed for all regions.
Perform all maintenance to the CHRISTUS Enterprise Charge Description Master (CDM). Process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections and on-going identified changes for current systems to maintain compliance with both state and federal regulatory agencies. Assists the Lead Charge Master Analyst in annual coding review and processing of updates.
Responsible for researching and processing regional requests for new item builds to ensure proper charging practices are maintained through regulatory and compliance guidelines.
Analyze data within the CDM and resolve errors as appropriate to ensure accurate assignment of revenue codes and CPT/HCPCS to preserve the integrity of the CDM and related systems.
Provide communication, education and assistance to Regional Leadership, Directors, Clinical Departments and Gatekeepers regarding annual and quarterly CPT/HCPCS changes or additions.
Coordinate and collaborate with Patient Financial Services, Hospital Information Management (HIM), Information Systems and regional department leaders monthly to ensure alignment with charge capture and audit initiatives and processes.
Ensures accurate patient billing according to governmental policies and CHRISTUS compliance and integrity policies.
Responsible for researching alternative procedures, software and equipment designed to improve operational effectiveness through comparison to comprehensive AMA/CPT and HCPCS service, drug, supply item grids as potential billable services.
Responsible for maintenance of selected CDM third party tool to ensure appropriate reimbursement through accurate charging.
Responsible for the ongoing analysis of Charge Description Master, billing system, Charge Capture Audit and clinical modules to identify claims related issues, proper utilization and compliance with regional pricing structure and methodology. Reports findings to Lead Charge Master Analyst.
Assists the Lead Charge Master Analyst in analyzing Charge Capture and Late Charge reports to identify regional variances and opportunities for additional revenue
Bachelors Degree in Business, Finance, Information Systems or Health Administration; some college courses in the above areas in conjunction with job experience equivalent to this position may be considered.
Strong quantitative analytical ability
Five to Ten years related experience in a hospital billing or finance setting.
Experience with coding and billing regulations
Experience with automated systems and interfaces
Intermediate to Advanced level knowledge of Excel or related application
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.