Ensures the integrity of the Charge Description Master (CDM) and charge capture processes by providing guidance on charged procedures, CPT codes, billing requirements, and compliance. Coordinates CDM changes across information systems, partners with the System Office CDM and Compliance team, and ensures CDM codes align with Medicare and local payer guidelines. Works with clinical departments and providers to improve revenue collection while maintaining compliance with local, state, federal, and third-party billing requirements.
Performs charge monitoring, follow-up, CDM maintenance, and resolution activities across departments. Reviews charge master content, audits charge capture processes, supports implementation of new charge codes and charge practices, and provides education on proper billing and coding workflows. Prepares reports and analysis, participates in committees and meetings, and serves as a liaison to payer strategy and compliance teams.
Qualifications
- Bachelor's degree in Healthcare, Business Administration, Finance, Accounting, Nursing, or a related field, or equivalent combination of education and experience.
- Five years of experience in billing, charge documentation, charge audit, charge capture, or related revenue cycle functions.
- Strong knowledge of clinical processes, charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes, and modifiers), charging processes, audits, and clinical billing.
- Working knowledge of CMS professional fee schedules, local Medicaid, and commercial payer requirements.
- Knowledge of third-party payer rules, computer operations, and electronic interfaces related to charge documentation, capture, and billing.
- Excellent interpersonal, verbal and written communication, organizational, analytical, and time management skills.
- Accuracy and strong attention to detail.
- CPC, CCS, or other recognized coding certification strongly preferred.
Location
Michigan, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 weeks ago