Charge Integrity Coordinator
Location: Danbury, Connecticut US
Requisition Number: 14842
Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations.
The Charge Integrity Coordinator is response for supporting and maintaining the Charge Description Master (CDM) for all Nuvance Health entities, including but not limited to, 7 hospitals and 4 physicians groups across two states. Responsible for the accuracy and completeness of the CDM and the interface of charges into the system and the linking of charges and services to the clinical build.
The CDM Coordinator supports the Charge Integrity team as well as the CDM Analyst role. Assists the Charge Integrity Team in the development of charge reconciliation reports and supports all audit, CDM and revenue and usage activity. Responsible for assisting in the build of the system wide CDM Tool as well as developing a process with IT to interface all charges and new codes into the billing and medical record system in order to ensure an accurate and timely Revenue Cycle. The Charge Integrity Coordinator oversees the integrity of the pricing of the CDM and the pricing maintenance in the Cerner systems and audits the charges after interfacing them in the system in collaboration with the CDM Analyst. The Charge Integrity Coordinator will be the subject matter expert relating to the CDM structure, CPT, HPHCS, revenue codes, industry trends, and deferral, state and payer regulations and guidelines.
- Perform daily reviews/analysis of charging errors, working with all Nuvance Health hospital and physician departments. Investigates, analyzes and recommends actions and solutions for registration, coding, charge entry, cash collection, posting and balance problems.
- Effectively support the Charge Description Master Maintenance coordination activities in a timely manner, including charge additions, CPT/HCPCS code changes, and pricing updates.
- Work with Charge Integrity Auditors and Revenue Cycle to identify, analyze and resolve CDM-related claim submission issues. Assist in the CEWL and EBEW error resolution. The CDM Coordinator will assist in the implementation and system build of the annual price adjustment.
- Participate in testing, validation and implementation of all system enhancements and upgrades to ensure that functionality, validation, transparency, charge and price accuracy is maintained. Evaluates, develops, and implements computer based departmental charge processes in collaboration with operating departments and ITG.
- Processes CDM additions, deletions and change requests in all systems, including CERNER MILLENIUM to maintain regulatory compliance and meet operational requirements.
- Builds exploding codes in CERNER. Ensures that Providers are attached to service codes at the departmental level to ensure correct billing. Assists in the streamlining of CDM codes across Nuvance Health in an effort to reduce charge line items in accordance with the Corporate Strategy.
- Collaborates with clinical departments and Nuvance Health resources to ensure appropriate inpatient, ancillary, clinical and billing modules are aligned with regard to standardized CDM maintenance process, quarterly and annual CPT/HCPCS updates. Identifies clinical workflows that will impact design build.
- Acts as a liaison with Charge Integrity, Managed Care, Access Services, Patient Accounting and the Service Lines regarding billing and pricing issues and concerns. Supports the activities of the Charge Integrity Audit Team by running reports and processing changes. Works closely with the CDM Analyst.
- Bachelor’s Degree in Business Administration, Accounting, Health Care Information Technology, Computer Science or a related area and/or equivalent combination of training and experience.
- Minimum of three (3) years relevant experience in CDM Management or IT. Patient Accounting experience preferred.
- Experience with large scale, automated patient billing systems, medical terminology and coding.
- In depth knowledge of electronic data interchange and claims processing, third party payer rules, reimbursement practices and regulatory guidelines.
- Experience working with revenue cycle information systems or system implementation teams for complex projects, application development and/or support.
- Technical knowledge of all revenue generation sources, including CDM, Charge Capture, CDI, Coding and all other related issues.
- In depth knowledge of the hospital and physician practices, procedures and all health care concepts related to healthcare revenue cycle and its component operations, including billing, collections, charge capture, coding compliance, managed care contractual terms, Medicare and Medicaid reimbursements, third-party reimbursements and cash management.
What We Offer:
- Medical, Dental, Vision
- Paid Time Off (PTO)
- Life and Disability
- Tuition Reimbursement
- In addition, we provide a range of voluntary benefits!!
Location: Summit-100 Reserve Rd
Work Type: Full-Time
Work Shift: 9am to 5:30pm
Salary Range: $31.25 - $46 Hourly Depending on Experience
EOE, including disability/vets.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.
Community / Marketing Title: Charge Integrity Coordinator
Health Quest and Western Connecticut Health Network have combined to form a new nonprofit health system. The name for the new health system will be Nuvance Health. The new health system was created to provide communities across New York’s Hudson Valley and western Connecticut with more convenient, accessible and affordable care.
EEO Employer Verbiage:
Location_formattedLocationLong: Danbury, Connecticut US
Job Number: 45022