CDM Specialist Sr

Overview

CDM Specialist Sr (Finance) – Nemours is seeking a Sr. CDM Specialist in Orlando, FL

This position is responsible for: assistance in maintenance of Charge Description Master (CDM) within Nemours hospital revenue producing departments. Works with the CDM/HB Manager to ensure an accurate CDM and Coding process resulting in clean and compliant claims. Acts as liaison and problem solver for CDM issues with Administration, insurance companies, charge capture departments, Health Information Management, Utilization Management, Recovery Auditors, Managed Care, Corporate Compliances, and Central billing Office (CBO).

• Responsible for the coordination of ongoing CDM consistency within revenue producing departments. Includes maintaining accurate descriptions, coding, in-activations, and revenue code assignments.
• Demonstrate and incorporate a working knowledge of the hospital's billing and coding software applications as related to coding and billing of encounters.
• Maintains an extensive working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist in cash collection while accurately complying with billing/coding guidelines.
• Reviews denials from CBO relating to payor rejections and incomplete reimbursement resulting from CDM issues, coding, and billing issues.
• Assists Recovery Audit staff with all CDM related hospital charge capture inquiries.
• Conducts research related to CDM and hospital billing issues using various types of information media: internet, payor intranet, payor newsletters and/or manuals.
• Works closely with EPIC IS application support relating to all CDM hospital billing functions: ADT (Admission Discharge Transfer), Ambulatory, Charge Router, Willow, and Radiant.
• Ability to read and comprehend the medical record to identify all diagnoses, procedures and services for the patient encounter for outpatient and emergency room services.
• Assists Coding Manager with coding duties.

Requirements:

• 5 years hospital billing and coding- 3-5 years of charge master experience
• Epic Certification within 1 year of hire
• Required COC or CPC
• Preferred HFMA CRCR, AAHAM, CRCS-I CHFP CRCS-P

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Nemours Children's Health is an internationally recognized children's health system. With more than 1.7 million patient encounters annually, we provide medical care in five states through two freestanding state-of-the-art children's hospitals - Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida. Our pediatric network includes 80 primary-urgent-and specialty care practices and more than 40 hospitalists serving 19 affiliated hospitals. We generate annual revenues of more than $1.7 billion derived from patient services, contributions from the Alfred I.

DuPont Trust, as well as other income.

As one of the nation's premier pediatric health systems, we're on a journey to discover better ways of approaching children's health. Putting as much focus on prevention as cures and working hand in hand with the community to make every child's world a place to thrive. It’s a journey that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention, leading to the healthiest generations of children ever.

Inclusion and belonging guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build an inclusive and supportive environment. All of our associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.

To learn more about Nemours Children's and how we go well beyond medicine, visit us ours.org.