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.
- 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.
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.
- Responsible for the oversight of CDM functions for Phoenix Children`s Hospital and all subsidiaries.
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.
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.
CDM Data File Access
- Provides CDM data file to all necessary PCH internal customers (e.g., UM, Managed Care, Financial Counseling).
Organizational Chargemaster Oversight
- Coordinates and facilitates the Chargemaster Oversight Group (COG) comprised of members from across the organization impacted by CDM related activities.
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.
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.
- Performs miscellaneous job related duties as requested.