Revenue Integrity Analyst

10100 Children's Hospital; United States; On-site; USD 65,000 - 109,000; Full time

Job summary

Children's National Hospital is seeking a Charge Master/CDM Specialist to coordinate the charge master system, ensure accurate coding and pricing, and advise clinical and administrative departments to optimize hospital revenue.

The role requires a 3+ year background in charge capture, coding, or CDM within a hospital, with an Associate degree; a Bachelor's in a healthcare field is preferred. Expect detailed data analysis and cross-department collaboration.

Qualifications

• Associate's Degree is required.
• Bachelor's in healthcare field is preferred.
• 3+ years in charge capture, coding or CDM in a hospital setting.

Responsibilities

• Coordinate the charge master system and updates.
• Assign CPT/HCPCS and revenue codes to ensure regulatory compliance.
• Educate and guide departments on CDM changes and charging practices.
• Review and maintain policies for CDM and pricing.

Skills

Charge capture

Coding

Education

Associate degree

Bachelor's degree in healthcare

Job description

Revenue Integrity

111 Michigan Avenue Northwest, Washington, DC 20010

Kids Are Our Everything. Department 10007

Pay Range: $65,124.80 - $108,555.20

The incumbent for this position is responsible for coordinating the charge master system and function, which is a listing of hospital services and procedures and the charges associated with those procedures. This position will utilize charge master management software and other resources to maintain a complete, accurate and standardized charge master. This position will provide charge master expertise, support, education, guidance and recommendations to clinical and administrative departments in order to optimize net revenue.

Minimum Education

• Associate's Degree (Required)
• Bachelor's Degree in Healthcare related field or equivalent work experience (Preferred)

Minimum Work Experience

• 3 years 3 - 5 years of experience in charge capture, coding or charge description master in a hospital environment (Required)

Functional Accountabilities

• Department Strategic Planning
• Provide education and in-service training to departments.
• Provide assistance and analysis to all levels of clinical management in support of suggested, requested and/or mandated changes to the CDM.
• Process CDM requests to ensure that all additions, changes and deletions are consistent with proper charging, billing, coding and pricing practices in a timely manner.
• Conduct annual review of the charge master and quarterly updates as appropriate to enhance revenue for the hospital departments.
• Analyze data within the CDM and assign accurate CPT/HCPCS and revenue codes to the Charge Master to insure compliance with regulatory agencies.
• Distribute coding and billing regulatory requirements and/or announcements to all applicable departments.
• Responsible to make CDM related decisions that require significant analysis and investigation.
• Develop and maintain policies and procedures for the CDM, Pricing Policies and charge capture processes.

Program and Service Administration and Implementation

• Perform all maintenance to the Charge Description and Service Master and the Room and Bed Master Files
• Create and maintain all hospital transaction codes and revenue department codes.
• Monitor and report all revenue department's charge volumes and posting lag days.
• Research and resolve all charge and service master related code errors that affect the recycle and reject reports.
• Assist in performing comprehensive reviews with clinical departments to ensure completeness and accuracy of charge description master.
• Take initiative to identify system and/or operational problems and participate in the development of solutions to improve billing functions.

Human Resources and Relationship Management

• Serve as expert resource for code and processing questions, train and educate coders.
• Maintain relationships with, and serve as liaison to department administration, physicians, clinic administration, information services, billing offices, financial offices and other departments.
• Participate in team meetings/activities and support the philosophy and goals of the team and department.
• Adhere to internal controls and reporting structure.
• Remain current with updated coding and billing regulations through yearly continuing education; read all announcements and relevant communications that relate to job duties.
• Lead special projects/assignments.

Safety

• Speak up when team members appear to exhibit unsafe behavior or performance
• Continuously validate and verify information needed for decision making or documentation
• Stop in the face of uncertainty and takes time to resolve the situation
• Demonstrate accurate, clear and timely verbal and written communication
• Actively promote safety for patients, families, visitors and co-workers
• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance

Other Responsibilities

The disclosed salary range includes the minimum and maximum rates within which Children's National believes an individual's base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children's National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual's combination of prior work experience, level of education, knowledge, skills, and other qualifications.

Children's National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible.

Equal Opportunity & Drug-Free Workplace

Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.

The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your RightsPay Transparency Nondiscrimination Poster.

Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana.