The CDM Analyst is responsible for oversight and maintenance of the hospital and professional Charge Description Master (CDM) within the Phoenix Children’s Hospital and all subsidiaries. As part of Revenue Integrity Department, the CDM Analyst will collaborate with multiple teams to ensure an efficient CDM maintenance process exists, resulting in clean and compliant claims. This position acts as liaison, problem solver and facilitator for CDM issues with Administration, Insurance Companies, Clinical Departments, Health Information Management, Utilization Management, Managed Care, Corporate Compliance and Revenue Cycle.

1. Support Revenue Integrity Team and Phoenix Children`s Strategic Revenue Cycle Plan
   • Supports the Revenue Integrity Team and Phoenix Children’s strategic Revenue Cycle plan by maintaining the CDM to ensure services rendered are accurately reported and reimbursed while maintaining compliance with all Federal and State regulations, payer policies, and coding guidelines.
2. Collaboration
   • Collaborates closely with the Revenue Integrity Team, all revenue producing Clinical Departments, Compliance, Hospital & Physician Business Offices, Transplant Revenue Cycle, Health Information Management (HIM), Information Technology (IT), Managed Care, and Finance to facilitate proper coding and billing outcomes.
3. Coordinate and Facilitate
   • Coordinates and facilitates the Chargemaster Oversight Group (COG) comprised of members from across the organization impacted by CDM related activities.
4. Monitors Federal, State and Payor Bulletins
   • Monitors Federal, State and Payer bulletins to identify updates that directly impact the CDM and proactively communicates applicable changes to the Clinical Departments affected.
5. Perform Research
   • Performs extensive research on regulatory guidelines and payer policies to address compliance, coding, and billing related inquiries related to the CDM.
6. Perform Daily Maintenance on CDM
   • Performs daily maintenance on the CDM including the addition of new charge codes, the inactivation of charge codes no longer performed/utilized and updates to Description, CPT/HCPCS, Revenue code, Modifier, Price, etc.
7. Collaborate with Other Departments
   • Collaborates with IT, Clinical Departments, etc. to establish accurate mapping and data flow from each subsystem to the CDM to ensure services rendered are accurately reported and reimbursed.
8. Perform Quarterly CDM Maintenance
   • Performs quarterly maintenance on the CDM including updates to Addendum B and the MPFS, analysis of new CPT/HCPCS, and material changes to reimbursement.
9. Perform Root Cause Analysis Resulting from CDM
   • Performs root cause analysis resulting from the CDM to resolve payor denials, coding/billing edits, and/or other delays or reductions to cash flow.
10. Implements Process Improvement
    • Implements process improvement strategies designed to streamline workflow, automate, and optimize technologies utilized as part of the CDM maintenance process.
11. Provides Focused Education
    • Provides focused education to clinical and coding stakeholders and best practice recommendations for improvement, as it relates to the CDM.
12. Assist with Validating Annual Pricing
    • Assists with validating annual pricing updates to the CDM to ensure accuracy and to optimize reimbursement within Phoenix Children’s budget requirements.
13. Performs miscellaneous job related duties as requested.

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

Values

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable