This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

This role involves managing all aspects of Charge Description Master (CDM) maintenance for Duke University Health System (DUHS), including audit, analysis, and verification of charging procedures.

• Responsible for the development, implementation, and maintenance of the CDM, ensuring accurate CPT/HCPCS and revenue coding.
• Works with revenue-producing departments to ensure ongoing coordination and consistency with the CDM and Charge Capture processes.
• Continuously reviews and updates regulations and maintains a current knowledge base.
• Interprets government regulations and affects related process changes to ensure compliance with these regulations.
• Performs daily audit maintenance functions to ensure compliance, accuracy, and consistency of the CDM.
• Works with internal controls and compliance to design audit processes, policies, and procedures.
• Assists in data analysis, periodic audits, and information queries, external audits, and special projects.
• Coordinates the annual CDM update process.
• Serves as an internal resource and expert on CDM issues and reporting.
• Assists with data entry, billing/audit questions, facility inquiries, education, database maintenance, statistical analysis, and processing of internal audits.
• Provides leadership and direction for departments on CDM strategies in accordance with state and federal regulatory guidelines.
• Makes recommendations for CDM process improvement.
• Provides system training and/or identifies other training resources to support CDM activities.
• Maintains a working knowledge of revenue cycle processes to aid in the implementation of regulatory standards.
• Works with DUHS Revenue Management and DUHS Finance to perform applicable analyses.
• Advises and collaborates with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel, and outside consultants.
• Meets regularly with CDM Analysts to help set priorities and assist with negotiating/eliminating barriers to success.
• Performs/assists with HR functions for the CDM team, including managing time and attendance and monitoring safety training requirements.
• Performs other related duties incidental to the work described herein.

Qualifications

• Bachelor's degree in business, healthcare administration, or a related field is required.
• Four years of related experience required.
• Coding certification is strongly preferred.
• Proficient in the use of Microsoft Office Programs, including Excel, Word, PowerPoint, and Access.
• Epic Certification preferred; Chargemaster Epic certification required within 6 months of hire.
• Extensive knowledge of CPT/HCPCS, UB-04 Revenue Coding, modifiers, billing regulations, and APCs.
• Good understanding of the CDM and its relationship to related areas such as the General Ledger, cost accounting, productivity, cost reporting, and budget.
• Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology.
• Ability to research complex coding and regulatory requirements.
• Strong analytical skills.

Company Description

Duke Health is committed to compassionate care that changes the lives of patients, their loved ones, and the greater community.