CDM Coordinator

2 weeks ago

Pittsburgh, PA, United States UPMC Full time

Purpose:

Functions as a financial liaison between the fiscal services division and patient care operations. The Coordinator provides education, training and communication on billing and revenue improvement measures, and operational efficiencies. Coordinates maintenance and upkeep of the charge description master (CDM). Performs statistical, cost and financial analysis of data reported in the financial systems. Provides assistance on financial compliance issues with the Compliance Officer.

Responsibilities:

  • Assist and interact with all levels of management within Finance and the Revenue Cycle, as well as others clinical areas.

  • Perform daily review/analysis of charging errors, working with ancillary departments to resolve in a timely manner.

  • Coordinate Charge Description Master maintenance coordination activities in a timely manner, including charge additions, CPT/HCPCS code changes, and pricing updates.

  • Work with PBS billing staff to identify, analyze and resolve CDM-related claim submission issues.

  • Establish and maintain collaborative, customer-focused relationships with all internal departments, as well as non-hospital groups or entities.

  • Investigates, analyzes and recommends actions and solutions for registration, coding, charge entry, cash collection, posting and balancing problems.

  • Support Finance and Revenue Cycle Services personnel with additional applications and software programs utilized within the Business Office.

  • Interact with personnel from Information Services, the CBO, and ancillary/clinical areas to ensure that all operational and revenue needs are met.

  • Participate in on-going performance improvement programs; program development, staff training and external conferences to ensure knowledge of billing and reimbursement regulations are current.

  • Support ancillary information system implementation efforts and other large-scale organizational projects by serving as CDM representative and identifying/analyzing/implementing CDM-related requirements.

  • Determine the needs of particular areas with regard to registration/billing requirements and serve as the liaison for all Information Service Requests.

  • Investigate and evaluate registration/billing problems to determine necessary actions required to resolve the problem.

  • Develop solutions to operational problems, create and implement action plans, as well as day-to-day operational revenue management.

  • Analyze ancillary departmental charging system/processes, recommending changes as necessary to ensure timely and accurate revenue capture and billing to third party payers.

  • Provide full cooperation and support to internal and external auditors by providing access to data, policies, or other requested material.

  • Participate in testing, validation and implementation of all system enhancements and upgrade to ensure that functionality and productivity is maintained.

  • Bachelor's degree in business administration, accounting, or computer sciences preferred.

  • Minimum of 10 years of patient account experience required.

  • Knowledge of basic patient accounting principles.

  • Familiarity with large-scale, automated patient billing systems, medical terminology and coding.

  • In-depth knowledge of electronic data interchange and claims processing, third party payer rules, reimbursement practices and regulatory guidelines.

  • Proficient with MS Word, Excel and Outlook.

  • Excellent client service skills.

  • Excellent written and verbal communication skills.

  • Ability to coordinate projects to meet the needs of users and establish priorities, make decisions and follow issues through resolution.

  • Strong leadership skills, oversight and direction for assigned special project activities.Licensure, Certifications, and Clearances:

  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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