Ensures the integrity of the Charge Description Master (CDM) and charge capture processes by providing guidance on procedures charged, CPT coding, billing requirements, and compliance issues. Coordinates and implements CDM updates across information systems and partners with System Office CDM and Compliance teams to maintain alignment with Medicare and local payer guidelines.
Works with clinical departments and providers across the ministry organization to support improvements in charging processes that enhance revenue collection while meeting local, state, federal, and third-party billing requirements.
Key responsibilities include charge monitoring, CDM maintenance, charge capture resolution, departmental audits, preparation of audit findings, recommendations to management, and education on correct charge capture, billing, and coding practices. The role also prepares reports and analysis, participates in committees and meetings, and serves as a liaison between payer strategy, CDM, and compliance teams.
Bachelor's degree in Healthcare, Business Administration, Finance, Accounting, Nursing, or a related field, or an 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, including CPT, HCPCS, ICD-9/10, revenue codes, and modifiers
- Charging processes and audits
- Clinical billing
- Professional fee schedules from CMS
- Local Medicaid and commercial payer requirements
- Third-party payer rules and requirements
- Computer operations and electronic interfaces related to charge documentation, capture, and billing
Excellent interpersonal, verbal, written communication, organizational, analytical, and time management skills.
Certified Professional Coder (CPC), CCS, or another recognized coding certification is strongly preferred.
Location
Michigan, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 weeks ago