Revenue Integrity CDM Coordinator

Louisiana Childrens Medical Co - New Orleans, LA (30+ days ago)


LCMC HEALTH MISSION STATEMENT:
For care. For community. For you.
LCMC Health is a Louisiana-based, not-for-profit healthcare system serving the needs of the people of Louisiana, the Gulf South and beyond. LCMC Health currently manages award-winning hospitals including Children’s Hospital New Orleans, Touro Infirmary, New Orleans East Hospital, University Medical Center New Orleans and West Jefferson Medical Center.

POSITION SUMMARY:
Reporting to the Revenue Integrity Manager, the Charge Description Master (CDM) Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. This position, working closely with the service line Revenue Integrity Liaisons is responsible for the maintenance and development of all Charge Description Masters (CDM) supporting the health system. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills. This position requires well-developed analytic, research, data management and organizational skills.

KEY RESPONSIBILITIES:
Maintains the corporate standard CDM to ensure CDM files are coded and structured for correct coding guidelines, billing guidelines and compliance with third party payor rules, supporting LCMC hospitals and physician practices. Leverages CDM Management tools to evaluate CDM through various compliance checks. Maintains hospital pricing and fee schedules associated with CDM, working within system policies and procedures.
Assigns charge codes as requested by revenue producing clinical departments and practices, working within system wide policies and procedures and with direction from Revenue Integrity Liaisons.
Works with Revenue Integrity Liaisons and clinical departments and practices to create new CDM items and pricing for new services and items.
Participates in complete revenue cycle reviews, including Charge Description Master (CDM) and related audits with a focus on CDM management.
Develops, implements and maintains CDM Management policies, procedures and training materials.
Analyzes and verifies charging procedures, charge capture and charge reconciliation protocols. Analyzes billing error and denial data to identify root causes. Executes on work plans to correct identified deficiencies.
Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications. Executes on work plans to adapt systems and processes to accommodate changes.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Must have advanced revenue code, CPT and HCPCS coding knowledge.
Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations
Solid understanding of multiple reimbursement systems including IPPS, OPPS, and Fee Schedule.
Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff.
Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel and Access.
Advanced knowledge of accurate sources for updating all applicable code sets (CPT/HCPCS, ICD-9, etc.).
Excellent organizational and project management skills.
Possess effective time management skills to permit handling of large workload.

EDUCATION/EXPERIENCE/LICENSURE:
Education: Bachelor’s Degree or equivalent work experience.
Experience (Type & Length):At least 3 years minimum recent experience in healthcare finance, revenue cycle management.
Certification/Licensure: Dual Hospital and Professional Coding Certification(s) preferred. (CPC, CPC-H, CCS, CCSP)