• Job Description

  Req#: 300000021027926
  Job Description
  
  Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
  
  The CDM Analyst is responsible for creating and maintaining the charge description master file based on correct CPT/HCPC coding and established charge methodology. The CDM Analyst will also train clinical staff in coding procedures and ensures coding and charge descriptions are compliant with industry standards, legal mandates, and reporting requirements. The accuracy of medical coding, charge descriptions, and hospital rates, as well as maximizing insurance reimbursement are other responsibilities.
  
  Responsibilities
  
  
  • Analyzes and conducts financial reviews to determine charge capture accuracy and comprehensiveness. Reviews include observance of operational procedures, documentation reviews, validation of data entry and final data capture and other aspects of operational audits.
  • Ensures accurate clinical charges, descriptions, and billing codes in the charge master. Ensures accurate crosswalk of charge master details with Epic clinical systems used for charge capture and clinical documentation.
  • Ensures compliance with pricing policy/practice. Performs annual and ongoing price changes.
  • Leads revenue enhancement projects, which includes working with denials management team, annual price analysis, organizational-wide project to standardize charges.
  • Manages communication of routine changes to coding, billing, and clinical departments.
  • Performs annual and ongoing CDM code updates. Serves as a coding resources to coders, clinics staff, and providers.
  • Responsible for resolving Epic WQs relating to missing charges, revenue guardian, missing price, missing cost center, etc.
  • Manage and assign CDM Alternate Codes/Payers
  • Maintain and Cost Center Assignment Table
  • Strong working knowledge of CCI/MUE edits to determine new or revised revenue guardian edits
  • Create Epic EAP records
  • Other duties as assigned
  
  Education
  • Bachelor's Degree - Healthcare related discipline or in pursuit thereof. - Required
  
  Work Experience
  • 5 Years - Coding/Billing experience preferred in health care industry, with specific experience typically obtained as a Coder. - Required
  • 3 Years - Prior experience with EPIC CDM, EAP and coding for HB and PB. - Required
  
  Licenses and Certifications
  • Certified Professional Coder (CPC) - Required Upon Hire Or
  • Registered Health Information Technician (RHIT) - Required Upon Hire Or
  • Registered Health Information Administrator (RHIA) - Required Upon Hire
  • Epic Certifications - EPIC Resolute Hospital Billing Charging Certification - Preferred Upon Hire Or
  • Epic Certifications - EPIC Resolute Professional Billing Revenue Integrity; Charge Capture and Coding - Preferred Upon Hire
  
  Travel Requirements
  • Travel to off site locations may be required. - Required
  
  
  Qualifications
  
  Skills and Abilities
  
  Essential Technical/Motor Skills
  
  • Demonstrated ability to provide coding advice to all areas of coding staff, CDI staff, other departments throughout Mosaic Life Care, and other entities as requested.
  • Broad knowledge of insurance regulations and Medicare and Medicaid guidelines as related to clinical documentation and clinical indicators.
  • Proficient in communicating clearly and effectively with various entities.
  • Proficient in computer usage, especially database and spreadsheet analysis.
  • Knowledge of organizational policies and procedures.
  • Skill in identifying problems and recommending solutions.
  • Proficiency in Microsoft Word, Excel, and Power Point required.
  
  
  Interpersonal Skills
  
  • Above normal ability to motivate, communicate and direct others with varying and/or diverse educational backgrounds to achieve department and organizational goals.
  • Ability to plan and organize education programs, as well as teach effectively and write education guides and handouts.
  • Must be able to communicate clearly.
  
  
  Essential Physical Requirements
  
  • Regularly required to sit, reach, bend, stoop, stand, and walk.
  • Must have ability to sit/stand for long periods of time.
  • Must have the ability to lift and/or move up to 10 pounds.
  • Must have the ability to travel throughout the organization as needed, as well as, be able to easily get in and out of vehicle when making home visits when necessary.
  
  
  Essential Mental Abilities
  
  • Ability to analyze complex clinical scenarios and apply critical thinking.
  • Proficient in navigating multiple systems to effect positive change.
  
  
  Essential Sensory Requirements
  
  • Hearing, speaking, and visual skills.
  
  
  Exposure to Hazards
  
  • Electrical output of personal computer, eye/neck strain.
  
  
  Other Skills and Abilities
  
  About Us
  
  Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.
  
  Mosaic has a wide array of benefits to meet each employee's individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.

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