CDM/Revenue Cycle Analyst
St. Luke's University Health Network, Allentown, PA, United States
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
Assists in the maintenance and updating of the network Charge Description Master (CDM) under the direct supervision of senior level staff members. Responsibilities include ensuring that all hospital services are added to the CDM per established policies and procedures. Involved in Network audit/review initiatives to ensure compliance with third party payer regulations and requirements related to the charge process. Responsible for verifying the accuracy of payments received for services rendered per third party payer contracts/other payment protocols.
JOB DUTIES AND RESPONSIBILITIES:
- Maintain volume within department work queues by collaborating with both clinical and revenue cycle staff throughout the issue resolution process.
- Assists management in the establishment of charges for new procedures, services, and supplies.
- Responsible for the initial pricing of hospital and professional services utilizing various pricing methodologies established for the Network.
- Ensures that the CDM complies with third party coding requirements regarding UB04 revenue codes, HCPCS/CPT codes.
- Assists in the maintenance and updating network CDM to ensure reimbursement maximization.
- Field customer service requests to ensure patient chart documentation supports the charges applied to the patient account.
- Updates Outpatient Workers Compensation Fee Schedules on a quarterly basis.
- Reviews third party correspondence (bulletins, Code Correct Informants, etc.) to identify possible additions and/or revisions to CDM/Epic system.
- Complies with all hospital and departmental policies and/or procedures.
- Maintains confidentiality of all materials handled within the Network/ Entity as well as the proper release of information.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Consistent use of hands and fingers for typing, telephone, data entry, etc. Occasional twisting and turning. Uses upper extremities to lift and carry up to 10 pounds. Stoops, bends and reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation. Seeing as it relates to general vision. Visual monotony when reading reports and viewing computer screen.
EDUCATION:
Four year degree in health administration, business, or related field is preferred.
TRAINING AND EXPERIENCE:
Two years of CDM maintenance experience is preferred.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!