CDM Analyst – Revenue Integrity
LCMC Health
full-time
Posted on:
Location Type: Remote
Location: Alabama • Florida • United States
Visit company websiteExplore more
About the role
- Review and analyze CDM data to ensure that all charge codes are accurate, current, and compliant with industry standards and payer regulations.
- Conduct regular audits of charge codes, procedure codes, and pricing to identify discrepancies or areas for improvement.
- Assist in updating the CDM by adding, modifying, or deleting charge codes as needed, in line with regulatory changes or departmental requests.
- Ensure that all changes to the CDM are appropriately documented and communicated to relevant departments.
- Analyze charge capture processes to ensure that services provided are accurately billed and correctly reflected in the CDM.
- Identify any missing or incorrect charges, working with clinical and billing teams to resolve issues.
- Ensure that all updates and modifications to the CDM adhere to regulatory guidelines, such as those from CMS, Medicare, Medicaid, and other payers.
- Monitor industry changes and payer updates to stay informed of new coding and billing requirements.
- Work with clinical, billing, and coding departments to address charge capture issues and ensure proper usage of CDM codes.
- Act as a resource for staff on CDM-related inquiries and charge coding concerns.
- Participate in audits of the CDM, assisting with the identification of any discrepancies in charge capture and compliance.
- Provide documentation and analysis during external audits, ensuring timely and accurate responses.
- Generate reports on CDM activity, including charge capture trends, audit results, and compliance metrics.
- Ensure the integrity and accuracy of CDM-related data by performing regular data quality checks.
- Identify opportunities to improve charge capture processes and optimize revenue by analyzing CDM usage and patterns.
- Provide recommendations for enhancing the efficiency and accuracy of CDM-related operations.
Requirements
- 3+ years of experience in healthcare auditing, revenue integrity, revenue cycle management, healthcare finance, or a related field
- Minimum of 2 years’ experience as an analyst in a healthcare environment with emphasis on chargemaster, revenue capture, charge auditing, reporting and reimbursement.
- Must have 3 years of experience in a hospital or professional based CPT-4, HCPCS Level II coding and outpatient ICD-10-CM coding experience for multiple hospital departments.
- Strong knowledge of Chargemaster (CDM) management, including charge capture processes, coding (CPT, HCPCS, ICD-10), and compliance with CMS and third-party payer requirements.
- 2+ years of Epic experience, particularly in managing work queues and charge capture functions.
Benefits
- 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 do.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
CDM managementcharge capture processesCPT codingHCPCS Level II codingICD-10-CM codinghealthcare auditingrevenue integrityrevenue cycle managementdata quality checksreporting
Soft Skills
analytical skillscommunicationproblem-solvingattention to detailcollaborationorganizational skillsresourcefulnessadaptabilitytime managementcritical thinking