CDM Analyst

 Apply!

Position Details

Department: CORP | Revenue Integrity
Category: Patient Financial Services
Location: Telecommuting
Employee Type: Regular
Posting #: 844308
Posted On: 6/19/2024

Position Summary

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.

Position Duties

  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.

Phoenix Children's Mission, Vision, & Values

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

Apply for this position?


Note, ONLY 1 attachment will be visible to system per applicant for all applications per active profile. When you upload your resume, our system will attempt to update your profile here, which may overwrite previously completed fields. The attached file is accepted as the resume. It is also allowable to combine both the resume (positioned first in the file) followed by a cover letter into the one file attachment.
Please upload a PDF or DOCX version of your resume. Resumes created in Mac Pages should be exported as PDF before uploading

or drag your file to this box

Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Education
Do you meet this requirement?
1. Bachelor`s degree in business, finance, data analytics, healthcare administration or health information management
Required
2. MBA, MSN or Master`s Degree
Preferred
Experience
Do you meet this requirement?
1. Five (5) years of healthcare revenue cycle experience demonstrating extensive CDM and compliance experience, ability to collaborate with multidisciplinary teams, and a solid foundational knowledge of general healthcare billing, Federal and State regulatory guidelines and payer policies, and compliant charge capture.
Required
2. Experience with hospital and professional coding guidelines, revenue audits, reimbursement methodologies, and system integration with the CDM relative to charge capture.
Required
3. Career appropriate experience based on job description essential functions.
Required
Certifications / Licenses / Registries
Do you meet this requirement?
1. Coding credential through AHIMA or AAPC (e.g., CPC, COC, CCS, CIRCC, RHIT, etc.).
Preferred
2. Healthcare Compliance credential (e.g., CHC, CRCM, CCEP, etc.).
Preferred
3. Nursing credential (e.g., RN, etc.).
Preferred
4. LEAN or Six Sigma training and certification
Preferred
Special Skills
Do you meet this requirement?
1. Expert knowledge of hospital and professional CDM structure and coding rules with effective research skills to ensure accuracy and compliance with regulatory guidance.
Required
2. Proven ability to determine key business issues and develop effective action plans from multi-disciplinary perspectives.
Required
3. Sound knowledge of general healthcare billing, payer contracting and reimbursement, and applicable Federal and State laws and regulations related to the healthcare industry.
Required
4. Demonstrated ability to effectively maintain subsystem integration with the CDM to optimize charge capture, identify revenue leakage and assist with root cause analysis.
Required
5. Excellent organizational and project management skills with a focus on time sensitive management and the ability to prioritize.
Required
6. Ability to impact change through influence and collaboration.
Required
7. Excellent communication and interpersonal skills, with the ability to communicate effectively in English, both verbally and in writing.
Required
8. Self-starter, well organized, and detail oriented.
Required
9. Proficient in electronic health systems.
Required
10. Proficient with Microsoft Office applications including: Outlook, Word, Excel, PowerPoint, Visio, and Access.
Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing - Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) - Constantly
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) - Constantly
4. Physical Requirement - Hearing - Constantly
5. Physical Requirement - Pushing/pulling - Occasionally
6. Physical Requirement - Reaching - Frequently
7. Physical Requirement - Sitting - Constantly
8. Physical Requirement - Standing - Frequently
9. Physical Requirement - Stooping/crouching/kneeling/crawling - Occasionally
10. Physical Requirement - Talking - Constantly
11. Physical Requirement - Tasting/smelling - Occasionally
12. Physical Requirement - Walking - Frequently
13. Physical Requirement - Near Vision - Constantly
14. Physical Requirement - Far Vision - Frequently
15. Physical Requirement - Color Discrimination - Frequently
16. Physical Requirement - Use of keyboard, mouse and/or computer equipment - Constantly
17. Physical Requirement - Lift up to 35 pounds without assistance - Occasionally
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply