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CDM Manager

Boston Medical Center (BMC) – Quincy, MA

Reporting to the Senior Director Revenue Integrity and Professional Billing Revenue Cycle, the Manager Revenue Integrity - Hospital & Professional CDM plays a leadership role in a group tasked with improving revenue results for the Medical Center and Medical Group.
This position is responsible for managing the routine review of the hospital and professional Charge Master for accuracy of CPT/HCPCS coding, including annual pricing and code set updates. With a focus on improving revenue and ensuring compliance with federal, local and third-party payer requirements, this manager will ensure required billing elements are in the system, and new charge code requests are handled timely and efficiently. This position is responsible for education of the department leadership relative to charge master issues and must demonstrate a strong commitment to stakeholder relationships by taking ownership of issues and facilitating effective outcomes in a timely manner. Establishing policies and procedures for all operations is also a critical success factor.
Bachelor s degree in Business/Healthcare related field or equivalent work experience.
Five to eight years minimum recent experience in healthcare finance, revenue cycle management, patient accounting and physician billing, coding and documentation preferably. Prior experience of managing/maintaining Chargemaster. Requires knowledge of CPT/HCPCS coding.
  • Knowledge of assigning and monitoring the accuracy of the CPT, HCPCS Level II coding parameters, revenue code selection in the Hospital and Professional Charge Master (CDM), modifier guidelines, proper diagnosis and procedure code selection, documentation guidelines and reimbursement guidelines with regard to charge entry throughout the hospital. Provide for an electronic audit trail for Charge Master changes, additions and deletions.* Working knowledge of multiple reimbursement systems including IPPS, OPPS and Fee Schedule and the ability to interpret and implement changes* Interviewing/listening skills required to enable talking with individuals and groups about current processes and issues to ask the right questions to yield essential information that will be used to evaluate processes and determine potential solutions.* Evaluate education-related needs related to CDM and conduct staff in-services.* Excellent management skills * Excellent time-management skills* Superior analytical skills to critically evaluate information gathered from multiple sources and synthesize into actionable information* Extensive technical skills to quickly learn hospital information systems as well as MS Office suite* Excellent writing, interpersonal and organizational skills
Boston Medical Center - 11 days ago - save job - original job

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