UMC Health System
Charge Description Master Coordinator
UMC Health System, Richmond, Kentucky, United States, 40475
Charge Description Master Coordinator
We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas. Job Summary: The Charge Description Master (CDM) Coordinator is responsible for managing and maintaining the hospital's CDM, ensuring the accuracy of charge codes, billing information, and compliance with regulatory standards. This role involves close collaboration with clinical, finance, billing, and coding departments to ensure charges align with current practices and guidelines. Reports to: Patient Financial Services, Manager of Revenue Integrity. Job Specific Responsibilities
Serve as the primary liaison between clinical departments and the revenue cycle team to address and resolve CDM-related issues. Work closely with clinical, finance, billing, and coding departments to verify that charges align with current practices and guidelines. Collaborate with revenue cycle and coding teams to identify opportunities to optimize charge capture, ensuring that all billable services are accurately reflected in the CDM. Identify and correct any missing, duplicate, or erroneous charge codes. Regularly review and update charge codes, procedure codes (CPT/HCPCS), and associated billing information. Monitor changes to coding, billing regulations, and payer requirements, updating the CDM as necessary. Conduct regular audits of the CDM to identify discrepancies, ensure accuracy, and mitigate any potential compliance risks. Respond to audit requests by providing charge code documentation and explanations as needed. Provide training and support to clinical and administrative staff on the correct usage of CDM codes and charge capture processes. All other related duties assigned. Education and Experience
Bachelor's degree in Accounting, Finance, Business, or related field of study. +5 years of related work experience in healthcare auditing, chargemaster, revenue integrity, revenue cycle management, healthcare finance, or related field. +3 years of Epic experience, particularly in managing work ques and charge functions. Required Licensures/Certifications/Registrations
Must have at (1) coding credential through AHIMA, HFMA, AAPC, or Epic certified. Skills and Abilities
Proficient Microsoft Office User, with advanced excel skills. Strong knowledge of Chargemaster (CDM) management, including charge capture processes, coding (CPT, HCPCS, ICD-10), and compliance with CMS and third-party payer requirements. Demonstrate knowledge of OPPS reimbursement methodologies, as well as Medicare reimbursement and billing guidelines, familiar with CMS transmittals and manuals, and with the cms.gov website to obtain quarterly HCPCS, OCE, and MUE updates. Demonstrate knowledge of NUBC revenue codes, mapping structures, UB-04 claim and payment remittance advice statements. Demonstrate knowledge of the medical necessity of services through the CMS Local and National coverage Determinations. Strong verbal and written communication skills. Ability to work independently with minimal supervision and in a team environment. Interaction with Other Departments and Other Relationships
The position requires interaction with many departments throughout the hospital, medical staff, and staff at Texas Tech University Health Sciences Center and Physician Network Services. Physical Capabilities
Work is of medium demand. Walking, sitting, and standing for extended periods of time may be required. Visual and auditory acuity required continuously. This position is subject to inside environmental changes that may include constant change in temperatures. Direct Reports: N/A UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Request for accommodations in the hire process should be directed to UMC Human Resources.
We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas. Job Summary: The Charge Description Master (CDM) Coordinator is responsible for managing and maintaining the hospital's CDM, ensuring the accuracy of charge codes, billing information, and compliance with regulatory standards. This role involves close collaboration with clinical, finance, billing, and coding departments to ensure charges align with current practices and guidelines. Reports to: Patient Financial Services, Manager of Revenue Integrity. Job Specific Responsibilities
Serve as the primary liaison between clinical departments and the revenue cycle team to address and resolve CDM-related issues. Work closely with clinical, finance, billing, and coding departments to verify that charges align with current practices and guidelines. Collaborate with revenue cycle and coding teams to identify opportunities to optimize charge capture, ensuring that all billable services are accurately reflected in the CDM. Identify and correct any missing, duplicate, or erroneous charge codes. Regularly review and update charge codes, procedure codes (CPT/HCPCS), and associated billing information. Monitor changes to coding, billing regulations, and payer requirements, updating the CDM as necessary. Conduct regular audits of the CDM to identify discrepancies, ensure accuracy, and mitigate any potential compliance risks. Respond to audit requests by providing charge code documentation and explanations as needed. Provide training and support to clinical and administrative staff on the correct usage of CDM codes and charge capture processes. All other related duties assigned. Education and Experience
Bachelor's degree in Accounting, Finance, Business, or related field of study. +5 years of related work experience in healthcare auditing, chargemaster, revenue integrity, revenue cycle management, healthcare finance, or related field. +3 years of Epic experience, particularly in managing work ques and charge functions. Required Licensures/Certifications/Registrations
Must have at (1) coding credential through AHIMA, HFMA, AAPC, or Epic certified. Skills and Abilities
Proficient Microsoft Office User, with advanced excel skills. Strong knowledge of Chargemaster (CDM) management, including charge capture processes, coding (CPT, HCPCS, ICD-10), and compliance with CMS and third-party payer requirements. Demonstrate knowledge of OPPS reimbursement methodologies, as well as Medicare reimbursement and billing guidelines, familiar with CMS transmittals and manuals, and with the cms.gov website to obtain quarterly HCPCS, OCE, and MUE updates. Demonstrate knowledge of NUBC revenue codes, mapping structures, UB-04 claim and payment remittance advice statements. Demonstrate knowledge of the medical necessity of services through the CMS Local and National coverage Determinations. Strong verbal and written communication skills. Ability to work independently with minimal supervision and in a team environment. Interaction with Other Departments and Other Relationships
The position requires interaction with many departments throughout the hospital, medical staff, and staff at Texas Tech University Health Sciences Center and Physician Network Services. Physical Capabilities
Work is of medium demand. Walking, sitting, and standing for extended periods of time may be required. Visual and auditory acuity required continuously. This position is subject to inside environmental changes that may include constant change in temperatures. Direct Reports: N/A UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Request for accommodations in the hire process should be directed to UMC Human Resources.