Business Analyst CDM

Summary

MISSION STATEMENT

• To advance the health and well-being of our community with a compassionate and caring spirit.

SUMMARY OF THE JOB

• This centralized position is responsible for assisting in the maintenance of the Charge Description Masters for all Deaconess Epic facilities. This includes responsibility for charge capture initiatives, price setting, 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 assisting with additional projects as assigned.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Job Duties include the following, other duties may be assigned: Assist in maintenance of Charge Master and Epic Procedure (EAP) Master Files accordance with government and commercial payers for accurate and compliance charging and to meet billing requirements; adding, deleting, activating, reactivating Epic charge codes. Ensure Epic and ancillary system charge master files are in sync. Stays current with government and commercial payer rules and regulations and applies changes to charge code set up. Participate in DHS revenue cycle committees and related work groups. May prepare and deliver training and education materials related to accurate charging and billing. May prepare agendas and supporting materials for charge master related meetings. Works with Finance, Health Information Management, Revenue Cycle Liaisons and/or Information Services departments 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. Provide continuous quality control through variance checks and trouble shooting. Must comply with Standards of Employee Conduct.
• Competencies: If applicable and not listed below, please refer to the department for required competencies.

JOB REQUIREMENTS & QUALIFICATIONS

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily and must clearly demonstrate all required competencies. The education/experience, certifications, skills, physical demands, and work environment described below further define requirements associated with this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Education and Experience Bachelor’s degree in healthcare-related field 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 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) credentials preferred.
• Other skills, ability or knowledge Requires 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, fee for service, and DRG payment methodologies. Experience with Microsoft Office (Outlook, Word, Excel, Power point, Access). 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. Knowledge of medical terminology. Strong leadership, communication, analytical and problem-solving skills.