Revenue Integrity Analyst CDM

Job Overview

This centralized position is responsible for assisting in the maintenance of the Charge Description Masters for all Deaconess Epic facilities. This includes the responsibility for charge capture initiatives, operational reviews, and working to ensure linkage between operations, billing, HIM and other areas are fully integrated and functional. Additional responsibilities include attending and supporting the DHS Revenue Cycle Team and additional projects as assigned.

Job Duties include the following, other duties may be assigned:

• Assist in maintenance of Charge Master and Epic Procedure (EAP) Master files in accordance with government and commercial payers for accurate and compliant charging; adding, activating, reactivating Epic charge codes.
• Ensure Epic and ancillary system charge master files are in sync.
• Stay current with government and commercial payer rules and regulations for application to charge code set up.
• Participate in work related groups.
• Prepare and deliver training and education related to accurate charging.
• Work with Finance, Health Information Management, Revenue Cycle Liaisons, and Information Services to identify critical charge related issues and resolve them in an expedient and proactive manner.
• Ability to provide valuable input for revenue cycle process improvement initiatives.
• Knowledge of ICD-10-CM, CPT/HCPCS procedure coding, UB-04 and 1500 billing requirements.

Education and Experience

• Bachelor’s degree in healthcare-related field is preferred.
• 2-3 years’ experience conducting charge description master set up and maintenance or an approved equivalent combination of education and experience.
• Epic charge master application experience is preferred.
• 2-3 years of coding experience in a hospital inpatient and outpatient setting is a plus.

Certificates, Licenses, Registrations

• None required. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) and/or Clinical Coding Specialist (CCS), and/or Certified Professional Coder (CPC) is preferred.

Other skills, ability or knowledge

• Extensive knowledge of government and commercial payer requirements to ensure accurate and compliant charging and billing of hospital inpatient, outpatient, surgical and ancillary services.
• Extensive knowledge of CPT, HCPCS, and revenue codes. Knowledge of APC and DRG payment methodologies.
• Extensive knowledge and application with Microsoft Office (Outlook, Word, Excel, Power Point).
• Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting).
• Knowledge of regulatory publications, how to access and interpret.