*CDM Analyst Revenue Integrity/ Full Time/Hybird Troy
Reporting to the CDM Manager, the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the accuracy and completeness of the CDM. The CDM Analyst also supports the CDM Coordinator and Senior CDM Analysts.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Reviews and/or processes changes, addition and deletion requests for CDM updates.
2. Follows HELIOS required change control processes for all updates/changes needed.
3. Participates in CAB call for Service Now Tickets submitted by Clinical and/or Operational departments. Routes/assigns Service Now tickets to
responsible CDM team members based on assigned departments.
4. Serves as technical resource for assigned clinical or business departments throughout HFHS. Responsibility includes, but is not limited to, the
assessment of optimization efforts to meet system goals including patient safety, quality of care, charge capture and improving operational
efficiencies.
5. Collaborates with EPIC Application teams, Reimbursement, Compliance, and SMEs to maintain/update/test the CDM and appropriate EAP records
and their links to these records for pricing and fee schedule maintenance
6. Supports timely implementation of coding updates (CPT/HCPCS), periodic UB Revenue Code updates, modifier revisions and regulatory updates to
CDM. Assists CDM Team with communications to Clinical End Users, Revenue Integrity, Reimbursement, IT, HIM and others (as needed) when
coding changes may impact net reimbursement, gross charges, productivity or internal processes.
7. Analyzes and processes charging and rate errors within EPIC Work Queues as well as other claim edit or charge review issues that occur.
8. Coordinates distribution of monthly CDM listings and reports to MedAssets and other users. Runs Jxports lists. Creates/runs other EPIC/CDM reports
as needed.
9. Reviews and requests changes to preference lists (charge navigators).
10.Performs a variety of duties within EPIC including, but not limited to, creation of EAPs in POC (Proof of Concept) environment and test PB
custom codes in POC or TST and updates fee schedule rates in POC for CDM Manager’s review.
11.Provides quality control check and audits that expected CDM changes have properly moved from test into the production environment.
12.With the CDM Manager and CDM Coordinator, collaborates with appropriate HELIOS application team or Subject Matter Experts (SME) to
maintain the various table files for providing accurate CPT/HCPCS and revenue codes within EPIC which are responsible for providing accurate
CPT/HCPCS codes and revenue codes based upon multiple payer requirements.
13.Adheres to HELIOS Service Level Agreements related to EPIC.
14.Analyzes legislation and regulations, reviews and interprets records, newsletters, bulletins, (billing and remittance) to comply with third party
regulations. This includes knowledge of Medicare/Medicaid regulations as well as understanding of managed care contracts.
15.Actively participates in ongoing monitoring process to identify billing problems related to the CDM to include: evaluation of the accuracy of
interface functionality, quarterly audit of the appropriateness of UB04 formatting for major payers and confirmation of the accuracy of
departmental charge capture tools (charge screens, charge sheets, etc.).
16.Participates collaboratively with Revenue Integrity team in the development, execution and follow-up of education programs for Administration,
Managers and Staff on all issues related to the charge master and charge master related processes.
17.Establishes and maintains effective working relationships with Nursing, Physicians, other Clinical Staff, Information Services, HIMS and PFS to
facilitate expeditious resolution of coding and billing issues related to the functionality of the CDM file and related interface processes.
18.Participates actively in team development, achieving dashboards, and in accomplishing department goals and objectives.
EDUCATION AND EXPERIENCE:
- Associates Degree Required,
- Bachelors Degree Preferred.
- Coding certification (CPC, COC, CCA, CCS, RHIT) Preferred.
- Charge Description Master experienc preferred.
- EPIC certification in CDM Management, PB or HB Claims certified preferred.
- If not EPIC CDM certified, must obtain EPIC CDM certification within 12 - 24 months of start date.
- Billing experience (professional and/or hospital) preferred.
- Clinical experience including RN, NP, RT, etc. a plus.
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, Â Â Â Â Â companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
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Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s Â
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.com.
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Â Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. Â My Choice Rewards is a program as diverse as the people it serves. Â There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. Â As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services. Employee's classified as contingent status are not eligible for benefits
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.