The CDM Analyst is responsible for oversight and maintenance of the hospital and professional Charge Description Master (CDM) within the Phoenix Children’s Hospital and all subsidiaries. As part of Revenue Integrity Department, the CDM Analyst will collaborate with multiple teams to ensure an efficient CDM maintenance process exists, resulting in clean and compliant claims. This position acts as liaison, problem solver and facilitator for CDM issues with Administration, Insurance Companies, Clinical Departments, Health Information Management, Utilization Management, Managed Care, Corporate Compliance and Revenue Cycle.
Education
Bachelor`s degree in business, finance, data analytics, healthcare administration or health information management (Required)
MBA, MSN or Master`s Degree (Preferred)
Experience
Five (5) years of healthcare revenue cycle experience demonstrating extensive CDM and compliance experience, ability to collaborate with multidisciplinary teams, and a solid foundational knowledge of general healthcare billing, Federal and State regulatory guidelines and payer policies, and compliant charge capture. (Required)
Experience with hospital and professional coding guidelines, revenue audits, reimbursement methodologies, and system integration with the CDM relative to charge capture. (Required)
Career appropriate experience based on job description essential functions. (Required)
Certifications
Coding credential through AHIMA or AAPC (e.g., CPC, COC, CCS, CIRCC, RHIT, etc.). (Required)
LEAN or Six Sigma training and certification (Preferred)
Special Skills
Expert knowledge of hospital and professional CDM structure and coding rules with effective research skills to ensure accuracy and compliance with regulatory guidance. (Required)
Proven ability to determine key business issues and develop effective action plans from multi-disciplinary perspectives. (Required)
Sound knowledge of general healthcare billing, payer contracting and reimbursement, and applicable Federal and State laws and regulations related to the healthcare industry. (Required)
Demonstrated ability to effectively maintain subsystem integration with the CDM to optimize charge capture, identify revenue leakage and assist with root cause analysis. (Required)
Excellent organizational and project management skills with a focus on time sensitive management and the ability to prioritize. (Required)
Ability to impact change through influence and collaboration. (Required)
Excellent communication and interpersonal skills, with the ability to communicate effectively in English, both verbally and in writing. (Required)
Self-starter, well organized, and detail oriented. (Required)
Proficient in electronic health systems. (Required)
Proficient with Microsoft Office applications including: Outlook, Word, Excel, PowerPoint, Visio, and Access. (Required)