RN, Auditor Patient Financial Services

Company: MemorialCare Health System
Location: Fountain Valley
Posted on: May 16, 2022

Job Description:

Purpose Statement / Position Summary

CDM Specialist will assist CDM Manager in maintaining and analyzing the Charge Master (CDM) for charge component compliance and revenue cycle integrity; monitoring compliance with Federal and State guidelines, performing periodic audits and provide education of Charge Description Master.

Essential Functions and Responsibilities of the Job

* Assist with the maintenance of CDM due to regulatory requirements as well as requests for services including but not limited to Charge Description, Revenue Code, CPT, modifiers and cost center for Adds, Changes and Inactivates to A/R system.
* Works collaboratively with IS to support applications and their subsystems for order entry and subsequent charges for specific discipline; i.e. laboratory, imaging, cardiology.
* Serves as a resource for staff throughout the health system involved in the revenue generation and charge master related issues and provides education on use of the Charge Master on the charging regulations.
* Develop and implements strategic goals of standardization and consolidation of charge/revenue systems and structures.
* Be at work and be on time
* Follow company policies, procedures and directives
* Interact in a positive and constructive manner
* Prioritize and multitas

Essential Job Outcomes

* Constructs charges in a timely manner to facilitate timely revenue cycle process.
* Resolves complex charging issues.
* Assures Charge Navigators are optimal and user friendly with CPT details for accurate charging.
* Collaborates with Ancillary systems and assigns appropriate CDM's for ordered procedures/tests.
* Educates Ancillary/Clinical departments regarding charge selection for service provided.
* Assists with Supply Chain Management in determining appropriate charge for chargeable item.
* "Other duties as assigned"

Experience

* Three to five years' experience in hospital Charge Master Maintenance preferably in a multi-hospital system.
* Knowledge of HIPPA compliance requirements.
* Working knowledge of CPT, HCPSCS Level II, Local Level III, ICD9 and ICD10 coding and associated clinical expertise.
* Familiar with Epic Resolute functionality preferred.
* Ability to multi task.
* Strong verbal and written skills.
* Demonstrate a high level of critical thinking skills.
* Rational and logical decision making abilities.

Education

* Current RN License
* Bachelor of Science in Nursing preferred
* Competent with MS Office with strong emphasis/skilled on Excel.

Keywords: MemorialCare Health System, Santa Monica , RN, Auditor Patient Financial Services, Accounting, Auditing , Fountain Valley, California