CDM Analyst – Revenue Integrity

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🏈 Alabama, Florida, +3 more states – Remote

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

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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LCMC Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

LCMC Health is a New Orleans-based, non-profit health system focused on providing exceptional healthcare to the communities of Louisiana and beyond. It operates eight hospitals and a network of clinics, prioritizing a hospitable and comprehensive approach to patient care. Founded by Louisiana's first freestanding children's hospital, LCMC Health treats patients like family and is dedicated to addressing the unique healthcare needs of the Gulf Coast region while fostering partnerships with local universities to advance healthcare practices and train future professionals.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

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