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Title

CDM Analyst - Salaried,1st/Variable 

Description

PURPOSE OF THIS POSITION

The primary purpose of the CDM Analyst position is to develop, implement and maintain the integrity of the CDM through effective management of the facility and professional charge-related dictionaries to insure compliance with Federal, State, Local and internal policy requirements.    The CDM Analyst is instrumental in providing decision-making support to all levels of the organization as it relates to revenue/financial management and initiatives, which includes, but is not limited to, the creation and analysis of data/reports; provide education to departments related to charge processes, compliance, changes to the CDM; support internal and external charge audit functions; participate on committees/projects, etc.

 

Duty 1: Works collaboratively with clinical departments and facilities to develop charges for new and revised procedures/programs which are compliant with regulatory requirements and internal policies. Assist in the evaluation of current charging, coding and auditing processes in clinical areas and make recommendations to insure optimal and accurate charge capture. Provide guidance and education to departments on appropriate charging and coding practices.

Duty 2: Maintain accurate Meditech (facility) and LSS (professional) charge dictionaries for BVRHC and BVMP and all departmental CDMs.  Communicate CDM dictionary changes and updates impacting other dictionaries or modules for charging, billing, coding and documentation, as appropriate (i.e. Order Entry, Med-Host, ITS, ORM, SI, etc.).  Report all dictionary changes that impact charge processes to affected department and/or system administrator.

Duty 3: Assist departments, including Patient Financial Service and Health Information Services, clinical departments, in resolving issues, edits, charging/billing errors or denials related to the charge master in accordance with regulatory guidelines. Prepares reports on non-compliance or error trends and works with the departments to facilitate compliance, ensure appropriate revenue capture, and/or reduce Accounts Receivable (AR) through appropriate and efficient process flow. Research issues, provide options and make recommendations to resolve identified issues.

Duty 4:   Active participant in the review, evaluation and implementation of the annual price increase in coordination with the Pricing Committee.  Review current pricing as compared to Ambulatory Payment Classification (APC), Physician Fee Schedule (PFS) and market data.  Support annual process to update BVHS website on top procedure pricing.  Provide back-up support to PFS to provide procedure cost estimates in response to patient inquiries.

Duty 5: Demonstrates good understanding of federal, state and third party charging guidelines to identify required changes to the CDM. Quantifies and provides comparative data to understand impact of how changes to the charges will financially impact the department or facility.  Provide CDM/charge-related data/reports for decision-making support, as requested and within scope.

Duty 6: Performs charge audit function (and enter TOB) to ensure optimal revenue integrity. Create reporting tool to monitor and track error trends. Provide education, feedback and documentation to clinical area on identified issues to support correct charging and coding at the point of charge entry.  Participates in external audits that may impact the CDM, coding/billing, compliance and/or charge capture/management processes.

Duty 7: Participates as a member on committees, task-force and/or projects, as appropriate, (i.e. Performance Improvement (PI), Value Analysis Committee (VAC), Pricing Committee, Denials Committee, etc.) to represent the perspective of CDM-related processes and regulatory compliance. Collaborates and provides support to Compliance, Planning & Budgeting, Finance, Revenue Cycle and Clinical Departments on revenue management initiatives.

Duty 8:  Analyze revisions to coding and billing rules by resourcing appropriate references (i.e. CMS website, Craneware, publications, professional contacts, reliable internet sources, seminars, etc.).  Create and execute work plans to successfully implement changes to system and/or process as necessary.

Duty 9:  Coordinates and/or participates in system testing as a result of upgrades, changes, enhancements, new application implementations, etc. that may impact the CDM, charge capture and/or charge data flow  between systems or modules. 

Duty 10: Serves as the system administrator for Craneware application; includes setting up access for end users, provide training, maintain scripting functionality (between Meditech, LSS and Craneware), and remain current on system features and functionality.  Utilize and create reports available in Craneware Toolkit to support management of the CDM, charging and revenue related functions.

Duty 11: Regularly attends and actively participates in staff meetings, in-services and continuing education programs as offered in order to remain current with organizational and industry changes.    Communicate and disseminate information to other departments as applicable.

Duty 12: Coordinate third party payer audit requests, review account documentation and prepare a defense audit based on findings and supporting medical record documentation. Report the outcome, along with any recommendations, to clinical area for corrective action and to appropriate compliance committee, as appropriate.

Duty 13:  Develop CDM-related departmental, division and/or organizational policies and procedures for recommendation and approval.

 
Position Requirements

REQUIREMENTS

  • An Associate or Bachelor’s degree in a related field including, but not limited to, health information, business, healthcare finance or related clinical profession or  5+ years’ experience from which comparable knowledge and abilities have been acquired.
  • ICD/DRG and/or CPT/APC coding and reimbursement concepts knowledge required.
  • Facility and/or professional coding and billing knowledge required.
  • Ability to research, review, analyze, and interpret Federal, State and Local billing regulations.
  • Proven competence in utilization of computer applications; including   Microsoft Office applications, with moderate-advanced skills in Excel; and experience with healthcare-related systems (Meditech, LSS and Craneware preferred).
  • Ability to compile, analyze and effectively present data in an informative and meaningful way.
  • Ability to manage complex issues and manage multiple tasks/projects. Excellent organizational and time management skills; detail oriented and follow through.
  • Strong problem-solving, research and analytical skills required.
  • Positive service-oriented interpersonal and communication skills required; Ability to effectively present and interact with all levels of the organization, including Senior Management.

 

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent activities in walking, lifting, bending, squatting, climbing, kneeling, and twisting. The associate will be required to sit for five hours a day. The individual must be able to lift ten to twenty pounds and reach work above the shoulders. This position requires corrected vision and hearing in the normal range. The individual must have excellent eye-hand coordination and verbal communication skills to perform daily tasks.

 
Full-Time/Part-Time Full-Time  
Exempt/Non-Exempt Exempt  
Department HIS 

Hours per Week 40 

BVHS Shift First 

Location Blanchard Valley Hospital  
About the Organization With more than 100 years of service behind us, BVHS is prepared to meet the challenges of the 21st century. We've grown from a single hospital to a comprehensive health system offering the Northwest Ohio region a full continuum of care.

Blanchard Valley Health System is a non-profit, integrated regional health system based in Findlay, a unique micropolitan community in Northwest Ohio. Governed by a community board of trustees representing large and small business, education, law, medicine and finance, BVHS oversees all operations.

BVHS has a long history of service to Findlay and the surrounding area. Blanchard Valley Hospital, the anchor subsidiary of BVHS, was founded in 1891 as the Findlay Home for Friendless Women and Children. As the community of Findlay has experienced growth and prosperity, so has the Health System, with major expansions occurring in 1958, 1967, 1977, throughout the 1980's and 1990's, 2007, and 2009.

BVHS is one of the largest employers in the area with more than 2,000 associates and serves an eight-county area that includes Hancock, Allen, Putnam, Henry, Wood, Seneca, Wyandot, and Hardin Counties.

In addition, a dedicated group of more than 600 volunteers support BVHS through their contributions of both time and money. As part of the BVHS family, the Auxiliary is a major contributor to our standards of excellence.
 

This position is currently not accepting applications.

To search for an open position, please go to http://bvhs.appone.com



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