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Position Details

Department: Revenue Integrity
Category: Patient Financial Services
Location: Phoenix
Posting #: 476034
Date Posted: 9/16/2019
Employee Type: Regular

Position Summary

This position is responsible for oversight and maintenance of Charge Description Master (CDM) within the Phoenix Childrens Hospital and all subsidiaries. As part of Revenue Integrity Department, the CDM Coordinator will work with Revenue Cycle to ensure an efficient front-end CDM process, resulting in clean and compliant claims. Acts as liaison, problem solver and facilitator for CDM issues with Administration, Insurance Companies, Charge Capture Departments (charge reconciliation), Health Information Management, Utilization Management, Managed Care, Corporate Compliance and Revenue Cycle.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. CDM Consistency with Revenue Producing Department
    • Responsible for the coordination of ongoing CDM consistency within revenue producing departments, which includes maintaining accurate descriptions, CPT coding, in-activations, pricing and revenue code assignments.
  2. CDM Functions
    • Responsible for the oversight of CDM functions for Phoenix Children`s Hospital and all subsidiaries.
  3. Working Knowledge of Revenue Cycle Process
    • Maintains an extensive working knowledge of the revenue cycle process to aid in the implementation of regulatory standards that assist in cash collection while accurately complying with billing guidelines.
  4. Analytic Trends and Review
    • Performs analyses, identifies trends and reviews denials from Revenue Cycle relating to payor rejections and incomplete reimbursements resulting from CDM issues. Research, develop and support revenue departments in chargemaster requests and reviews.
  5. CDM Data File Access
    • Provides CDM data file to all necessary PCH internal customers (e.g., UM, Managed Care, Financial Counseling).
  6. Organizational Chargemaster Oversight
    • Coordinates and facilitates the Chargemaster Oversight Group (COG) comprised of members from across the organization impacted by CDM related activities.
  7. Federal and State Regulation Updates
    • Monitor Federal and commercial bulletins for HCPCS/CPT code changes and additions and billing unit rule changes that affect functions of PCH, PCMG; and PCP.
  8. Budget and Net Revenue impact
    • Works with Hospital Finance and Decision Support managers to understand budget, net revenue and expense impacts resulting from CDM data file. Coordinates scheduled pricing updates and facilitates all software file updates.
  9. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. Bachelor`s Degree in Business, Health Information Management, Health Care Administration or related field. Required
2. Master`s Degree in Business, Health Information Management, Health Care Administration or related field. Preferred
Do you meet this requirement?
Experience
1. Two (2) or more years experience with hospital charge description master maintenance, auditing and billing compliance, including reimbursement, charge entry, and coding. Required
2. Experience in CDM function and application requirements (CPT codes, Revenue Codes, and coverage issues). Required
3. Experience with CPT/HCPCS including facility coding and reimbursement software. Required
4. Experience with current coding compliance regulations, and developing issues and trends in coding procedures and requirements. Required
5. Experience with Revenue audits, charge reconciliation and process flow development Preferred
6. Experience with coding practices (primarily CPT-4 and HCPCS Level II Codes). Preferred
7. Experience with Hospital Revenue Cycle processes for claim generation and submission, systems technology, billing pre and post edits, medical necessity guidelines, payer processing requirements and claim/medical records audit procedures. Preferred
Do you meet this requirement?
Certifications/Licenses/Registries
1. Coding Certification through AHIMA or AAPC Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Hearing Frequently
2. Physical Requirement - Reaching Occasionally
3. Physical Requirement - Sitting Constantly
4. Physical Requirement - Standing Occasionally
5. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
6. Physical Requirement - Talking Occasionally
7. Physical Requirement - Walking Occasionally
8. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
9. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
10. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
11. Occupational Exposure/Risk Potential - Inside office environment Applicable
12. Occupational Exposure/Risk Potential - Outdoor weather conditions Applicable
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply