CDM Analyst – Revenue Integrity

🕒 vor 2 Monaten

🏈 Alabama, Florida, +3 weitere Bundesländer – Remote

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

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

🧐 Analyst

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LCMC Health

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10.000+ Mitarbeiter

Wir glauben, dass ein Krankenhaus tatsächlich gastfreundlich sein sollte.

Beschreibung

• Review and analyze CDM data to ensure that all charge codes are accurate, current, and compliant with industry standards and payer regulations. • Conduct regular audits of charge codes, procedure codes, and pricing to identify discrepancies or areas for improvement. • Assist in updating the CDM by adding, modifying, or deleting charge codes as needed, in line with regulatory changes or departmental requests. • Ensure that all changes to the CDM are appropriately documented and communicated to relevant departments. • Analyze charge capture processes to ensure that services provided are accurately billed and correctly reflected in the CDM. • Identify any missing or incorrect charges, working with clinical and billing teams to resolve issues. • Ensure that all updates and modifications to the CDM adhere to regulatory guidelines, such as those from CMS, Medicare, Medicaid, and other payers. • Monitor industry changes and payer updates to stay informed of new coding and billing requirements. • Work with clinical, billing, and coding departments to address charge capture issues and ensure proper usage of CDM codes. • Act as a resource for staff on CDM-related inquiries and charge coding concerns. • Participate in audits of the CDM, assisting with the identification of any discrepancies in charge capture and compliance. • Provide documentation and analysis during external audits, ensuring timely and accurate responses. • Generate reports on CDM activity, including charge capture trends, audit results, and compliance metrics. • Ensure the integrity and accuracy of CDM-related data by performing regular data quality checks. • Identify opportunities to improve charge capture processes and optimize revenue by analyzing CDM usage and patterns. • Provide recommendations for enhancing the efficiency and accuracy of CDM-related operations.

🎯 Anforderungen

• 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 with emphasis on chargemaster, revenue capture, charge auditing, reporting and reimbursement. • Must have 3 years of experience in a hospital or professional based CPT-4, HCPCS Level II coding and outpatient ICD-10-CM coding experience for multiple hospital departments. • Strong knowledge of Chargemaster (CDM) management, including charge capture processes, coding (CPT, HCPCS, ICD-10), and compliance with CMS and third-party payer requirements. • 2+ years of Epic experience, particularly in managing work queues and charge capture functions. • An associate’s degree in healthcare administration, health information management, or a related field is required. • Preferred: Bachelor's degree in healthcare. • AAPC or AHIMA credential or Epic Certified preferred.

🏖️ Vorteile

• Deliver healthcare with heart. • Give people a reason to smile. • Put a little love in your work. • Be honest and real, but with compassion. • Bring some lagniappe into everything you do. • Forget one-size-fits-all, think one-of-a-kind care. • See opportunities, not problems – it’s all about perspective. • Cheerlead ideas, differences, and each other. • Love what makes you, you - because we do.