Senior CDM Analyst

Location
Silver Spring, Maryland-Silver Spring
Posted
Oct 13, 2021
Closes
Nov 17, 2021
Ref
2100033H
Function
Nurse
Industry
Healthcare
Hours
Full Time
The Senior CDM Analyst will report to the CDM Supervisor and demonstrate expertise in charge workflows, billing compliance and charge analysis in the pediatric medical setting. The Senior CDM Analyst will review, analyze, charge workflows and pricing model/logic for either technical and/or professional services to support compliant billing practices. The Senior CDM Analyst will discover possible system/Charging issues for resolution. Will support CDM Supervisor with pricing tools, charge workflow changes and support the testing of charge capture workflows for new locations and service lines. The Sr CDM Analyst function will ensure compliance with established charging guidelines, third party reimbursement policies, CMS regulations and accreditation guidelines.

Qualifications

Minimum Education
Associate's Degree or Relevant experience beyond the minimum required work experience may substitute the educational requirement on a 1-to-1 ratio." (i.e., one year of relevant work experience equals one year of required education). (Required)
Bachelor's Degree Healthcare related field (Preferred)

Minimum Work Experience
4 years Experience in charge capture, coding or charge description master in a hospital environment for hospital and professional services. (Required)

Required Skills/Knowledge
Demonstrates excellent organizational and problem solving skills.
Ability to delegate assignments and follow through on details is essential.
Excellent internal and external customer service skills required.
Must possess ability to be effective and efficient in a fast paced environment, managing multiple competing tasks and priorities.

Required Licenses and Certifications
COC/CPC Coding Certification (Preferred)

Functional Accountabilities
Department Strategic Planning

  • Validate and approve access to all charge workflows and charge corrections, as directed by the CDM Supervisor.


  • Provide education and in-service training to departments in collaboration with CDM Supervisor
  • Provide assistance and analysis to all levels of clinical management in support of suggested, requested and/or mandated changes to the CDM.
  • Process complex CDM requests to ensure that all additions, changes and deletions are consistent with proper charging, billing, coding and pricing practices in a timely manner.
  • Conduct annual review of the charge master and quarterly updates as appropriate to enhance revenue for the hospital departments, including review of supplies, lab charges and pharmacy charges.
  • Analyze data within the CDM and assign accurate CPT/HCPCS and revenue codes to the Charge Master to insure compliance with regulatory guidance, per Billing and Coding industry norms.
  • Distribute coding and billing regulatory requirements and/or announcements to all applicable departments.
  • Responsible to make CDM related decisions that require significant analysis and investigation.
  • Assist with developing and maintaining policies and procedures for the CDM, Pricing Policies and charge capture processes.

Program and Service Administration and Implementation

  • Perform all maintenance to the Charge Description and Service Master and the Room and Bed Master Files


  • Create and maintain all hospital transaction codes and revenue department codes.
  • Monitor and report all revenue department's charge volumes and posting lag days.
  • Research and resolve all charge and service master related code errors that affect the recycle and reject reports.
  • Assist in performing comprehensive reviews with clinical departments to ensure completeness and accuracy of charge description master.
  • Take initiative to identify system and/or operational problems and participate in the development of solutions to improve billing functions.

Human Resources and Relationship Management

  • Serve as expert resource for code and processing questions, train and educate coders.


  • Maintain relationships with, and serve as liaison to department administration, physicians, clinic administration, information services, billing offices, financial offices and other departments.
  • Participate in team meetings/activities and support the philosophy and goals of the team and department.
  • Provide individual feedback and goal setting recommendations as directed by the Sr Manager
  • Adhere to internal controls and reporting structure.
  • Remain current with updated coding and billing regulations through yearly continuing education; read all announcements and relevant communications that relate to job duties.
  • Lead special projects/assignments as directed by the CDM Supervisor.


Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification

  • Anticipate and responds to customer needs; follows up until needs are met


Teamwork/Communication
  • Demonstrate collaborative and respectful behavior
  • Partner with all team members to achieve goals
  • Receptive to others' ideas and opinions


Performance Improvement/Problem-solving
  • Contribute to a positive work environment
  • Demonstrate flexibility and willingness to change
  • Identify opportunities to improve clinical and administrative processes
  • Make appropriate decisions, using sound judgment


Cost Management/Financial Responsibility
  • Use resources efficiently
  • Search for less costly ways of doing things


Safety
  • Speak up when team members appear to exhibit unsafe behavior or performance
  • Continuously validate and verify information needed for decision making or documentation
  • Stop in the face of uncertainty and takes time to resolve the situation
  • Demonstrate accurate, clear and timely verbal and written communication
  • Actively promote safety for patients, families, visitors and co-workers
  • Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance


Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.

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