CDM Analyst – Revenue Integrity

🕒 Agosto 14

🏈 Alabama, Florida, +3 estados a mais – Remoto

🏈 Alabama – Remote 🐊 Florida – Remote ⚜️ Louisiana – Remote 🎸 Mississippi – Remote 🤠 Texas – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista

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LCMC Health

SiteLinkedInTodas as Vagas

10.000+ funcionários

🏥 Saúde

🤝 Sem Fins Lucrativos

Healthcare • Non-profit

Acreditamos que um hospital deve realmente ser acolhedor.

Descrição

• Review and analyze Charge Description Master (CDM) data for accuracy, currency, and compliance. • Conduct audits of charge codes, procedure codes, pricing, charge capture, and compliance. • Add, modify, or delete charge codes in response to regulatory changes or departmental requests. • Document and communicate CDM changes to relevant departments. • Analyze billing and charge capture processes and resolve missing or incorrect charges with clinical and billing teams. • Monitor CMS, Medicare, Medicaid, and payer coding and billing requirements. • Collaborate with clinical, billing, and coding departments on CDM-related issues. • Act as a resource for staff on CDM inquiries and charge coding concerns. • Support internal and external audits with documentation, analysis, and timely responses. • Generate reports on CDM activity, trends, audit results, and compliance metrics. • Perform data quality checks and recommend process improvements to optimize revenue and CDM operations.

🎯 Requisitos

• Must be a resident of Texas, Louisiana, Mississippi, Alabama, Florida, or Georgia. • 3+ years of experience in healthcare auditing, revenue integrity, revenue cycle management, healthcare finance, or a related field. • Minimum of 2 years’ experience as an analyst in a healthcare environment focused on chargemaster, revenue capture, charge auditing, reporting, and reimbursement. • 3 years of hospital or professional CPT-4, HCPCS Level II, and outpatient ICD-10-CM coding experience across multiple hospital departments. • Strong knowledge of Chargemaster/CDM management, charge capture, CPT, HCPCS, ICD-10, CMS, and third-party payer requirements. • 2+ years of Epic experience, particularly work queues and charge capture functions. • Associate’s degree in healthcare administration, health information management, or a related field required. • Knowledge of OPPS, Medicare reimbursement and billing guidelines, CMS transmittals and manuals, HCPCS, OCE, and MUE updates. • Knowledge of NUBC revenue codes, mapping structures, UB-04 claims, and payment remittance advice statements. • Knowledge of CMS Local and National Coverage Determinations and medical necessity. • Working knowledge of medical terminology, CPT, HCPCS, ICD-10, and Revenue Codes. • Knowledge of Medicare, Medicaid, Medicare OPPS reimbursement, third-party billing rules, and coverage determinations. • Advanced computer skills, including spreadsheets, word processing, databases, Microsoft applications, and ability to learn new systems quickly. • Advanced Excel and Office 365 proficiency, including Word, Excel, PowerPoint, Outlook, Teams, and SharePoint. • Demonstrated process improvement, analytical, problem-solving, organizational, and multitasking skills. • Ability to work independently with minimal supervision and in a team environment. • Strong verbal and written communication skills, including formal reports, analyses, and presentations. • Significant experience with CPT, ICD-10, and UB-04 billing. • Preferred: Bachelor’s degree in healthcare. • Preferred: AAPC or AHIMA credential or Epic Certified.

🏖️ Benefícios

• Equal opportunity employment • Work shift: Days (United States of America)