Summary
Job Summary: The Charge Description Master (CDM) Analyst is responsible for designing, monitoring, maintaining and updating the charge master for Alameda Health System. Determines the CPT/HCPCS codes, revenue center codes and billing information to support accurate and correlated to each payer. Accountable for the information in the charge master and that it conforms to overall organizational billing practices and is compliant with current coding and billing laws.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Provides support to the Revenue Integrity Manager in the maintenance of Alameda Health System’s standardized chargemaster according to defined change management protocols.
2. Provides chargemaster updates to adhere to appropriate reimbursement and compliance with governmental billing regulations which includes updating chargemaster codes related to annual CPT updates, quarterly HCPCS updates, payor specific updates (e.g. Medi-Cal, CPSP, etc.)
3. Processes CDM change requests and coordinates with SAPPHIRE IT team to implement the specific changes and maintain timely turnaround of all chargemaster requests.
4. Adheres to corporate procedures for additions, deletions, and other changes to the charge master to support an accurate database.
5. Works with the revenue producing departments to support the ongoing coordinated consistency of the chargemaster, including accurate descriptions, coding, additions, deletions, pricing, and any other changes.
6. Collaborate with managerial and supervisory billing staff to support accurate regulatory billing.
7. Develops and utilizes tools to trend, analyze and interpret changes in reimbursement specific to coding and charge master initiatives.
8. In partnership with the SAPPHIRE IT team, updates and maintains the EAP (Epic All Procedures) to support correct billing fields are populated.
9. Partner with departments in reviewing preference lists and order panels for accuracy, and work with the EPIC clinical team to support that users can access correct charges.
10. Perform audits when new charging logic is being implemented, when new service codes are being added to the EAP, or when new modules are being implemented in EPIC.
11. Discuss results with managers/EPIC team/revenue cycle and clinical leadership and provide education to the necessary departments as needed to solve charge related issues.
12. Trains new chargemaster analysts and provides quality checks as directed and participates in ongoing coordination and resolution of revenue issues as they arise
13. Keeps expertise and current with all regulatory (CCI, NUBC, etc.) and CPT/HCPCS updates and other appropriate charging and billing rules.
Qualifications
Preferred Education: Associate’s Degree preferred. Required Education: High school diploma or G.E.D.
Minimum Experience: Two years in a charge description master (CDM) related work, broad-based knowledge of hospital financial operations including reimbursement, coding and charge capture processes and State and Federal regulations.
Required Licenses/Certifications: Certified Professional Coder (CPC), or Certified Coding Specialist (CCS), required within 1 year of employment.