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Reporting to the Revenue Integrity Manager, the Charge Description Master (CDM) Coordinator is responsible for managing and maintaining the hospital’s CDM, ensuring accuracy of charge codes, billing information, and compliance with regulatory standards.
Your Everyday
Ensure the hospital's CDM is accurate, up-to-date, and compliant with all federal, state, and payer regulations.Regularly review and update charge codes, procedure codes (CPT/HCPCS), and associated billing information.Work closely with clinical, finance, billing, and coding departments to verify that charges align with current practices and guidelines.Serve as the primary liaison between clinical departments and the revenue cycle team to address and resolve CDM-related issues.Ensure CDM updates comply with regulations from agencies like CMS, Medicare, Medicaid, and other third-party payers.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.Offer educational sessions on regulatory updates, coding changes, and their impact on the CDM.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.Maintain data integrity within the CDM system by ensuring the accuracy of pricing, codes, and descriptions.Generate reports on CDM usage, compliance, and charge capture trends for leadership review.Assist in the development of policies and procedures related to the CDM, ensuring consistent application of coding standards and compliance measures.The Must-Haves
Minimum:
EXPERIENCE QUALIFICATIONS:
Ensure the hospital's CDM is accurate, up-to-date, and compliant with all federal, state, and payer regulations.Regularly review and update charge codes, procedure codes (CPT/HCPCS), and associated billing information.Work closely with clinical, finance, billing, and coding departments to verify that charges align with current practices and guidelines.Serve as the primary liaison between clinical departments and the revenue cycle team to address and resolve CDM-related issues.Ensure CDM updates comply with regulations from agencies like CMS, Medicare, Medicaid, and other third-party payers.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.Offer educational sessions on regulatory updates, coding changes, and their impact on the CDM.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.Maintain data integrity within the CDM system by ensuring the accuracy of pricing, codes, and descriptions.Generate reports on CDM usage, compliance, and charge capture trends for leadership review.Assist in the development of policies and procedures related to the CDM, ensuring consistent application of coding standards and compliance measures.EDUCATION QUALIFICATIONS:
Minimum - bachelor’s degree in accounting, Finance, Business, Healthcare, Analytics or another related fieldPreferred - master’s degree in accounting, Finance, Business, Healthcare, Analytics or another related field.LICENSES AND CERTIFICATIONS:
Must have at least one coding credential through AHIMA, HFMA, AAPC, or EPIC certified.SKILLS AND ABILITIES:
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 statementsDemonstrate knowledge of the medical necessity of services through the CMS Local and National coverage DeterminationsDemonstrated ability to establish and maintain effective working relationships at all levels.Demonstrated ability to work independently.Working knowledge of medical terminology, CPT, HCPCS, ICD 10, and Revenue Codes.Demonstrated knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and third-party billing rules and coverage determinations.Demonstrated high level of computer skills, including spreadsheet programs, word processing, database programs, and various Microsoft applications and the ability to quickly learn and utilize new systems.Demonstrated ability to handle multiple responsibilities simultaneously and problem solve.The ability to think both creatively and analytically.Demonstrated process improvement skills.Demonstrated proficiency in verbal and written communication including writing and presenting formal reports, analysis and presentationsSignificant work experience in CPT, ICD10, and UB04 billingKnowledge of medical terminology requiredStrong analytical, problem solving, and organizational skillsAbility to work independently with minimal supervision and in a team environmentCompetent in business functions, procedures, and information flowsStrong verbal and written communication skillsComputer skills including epic and file management (importing, downloading, and merging files), word processing, spreadsheet, and database management programsAdvanced excel skillsOffice 365 (Word, Excel, PowerPoint, Outlook, Teams, Share point)WORK SHIFT:
Days (United States of America)LCMC Health is a community.
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary
Your extras
Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we doYou are welcome here.
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
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