Requisition #: 212052
Title: Specialist, CDM
Posting Date: January 14, 2021
Hours: 40 hours
Shift Length: 8 hours
Location: UMass Memorial Health Care – 306 Belmont St, Worcester, MA
Serves as a Charge Description Master (CDM) and regulatory gatekeeper to ensure compliance with coding and billing guidelines. Reviews all assigned edits within prescribed timeframe and routes to appropriate owner for resolution. Provides regulatory coding and billing support to Clinical Charge Capture Specialists to address CDM, coding, charge capture and billing questions.
- Serves as a gatekeeper to ensure that routine and annual CDM updates are in compliance with all governmental and commercial payers regulatory coding and billing guidelines and reflect clinical practice.
- Collaborates with clinical / ancillary departments and Information Technology (IT) department to facilitate appropriate use of CDM, maintain CDM requests and synchronize preference lists and orders in IT applications, as appropriate.
- Promotes system wide compliance with federal, state and local regulations with regard to charge codes and related information in the CDM.
- Promotes a standardized, system–wide CDM.
- Reviews and resolves all assigned charge edits within prescribed timeframe.
Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related.
3-5 years of work experience related to billing and coding. Minimum of two (2) years of work experience required. Knowledge of industry standard practices, including ICD, CPT / HCPCS codes and third party reimbursement policies. Knowledge of coding and billing requirements based on third party publications and policies. Strong interpersonal and communication skills required. Ability to speak and present in front of groups required. Detail oriented, strong analytical skills with the ability to multi task and prioritize required. A working knowledge of Microsoft Office applications, ability to develop reports and create presentations.
Coding Certification (e. g. Certified Outpatient or Professional Coder, American Academy of Professional Coders).
Standards of Respect: