Claims Auditor 25-00412
Alura Workforce Solutions
Fountain Valley, CA
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JOB DETAILS
LOCATION
Fountain Valley, CA
POSTED
30+ days ago
CDM Auditor
Position Type: Temporary
Schedule: M-F, 8:00 am - 5:00 pm
Assignment Length: Approximately 4-Months, possibly Longer.
DESCRIPTION
CDM Auditor will assist the Chargemaster, RCM team in maintaining and analyzing the Charge Master (CDM) for charge component and revenue cycle integrity; monitoring compliance with Federal and State guidelines, performing periodic audits and provide education of Charge Description Master.
Job Responsibilities:
- Assist with the maintenance of CDM due to regulatory requirements as well as requests for services including but not limited to charge description, revenue Code, CPT, modifiers and cost center for updates to the A/R system.
- Works collaboratively with IS to support applications and their subsystems for order entry and subsequent charges for specific discipline, i.e. laboratory, imaging, cardiology.
- Serves as a resource for staff throughout the health system involved in the revenue generation and charge master related issues and provides education on use of the Charge Master on the charging regulations.
- Develop and implement strategic goals of standardization and consolidation of charge/revenue systems and structures.
- Be at work and be on time. Prepared for meetings, works on assignments, and provides feedback on projects. Reliable internet access and maintains connectivity. Communicates timely by phone, email, and/or other departmental resources.
- Follow company policies, procedures and directives.
- Interact in a positive and constructive manner.
- Prioritize and multitask.
- Qualifications - External
- Essential Job Outcomes
- Constructs charges in a timely manner to facilitate timely revenue cycle process.
- Resolves complex charging issues.
- Assures Charge Navigators are optimal and user friendly with CPT details for accurate charging.
- Collaborates with ancillary systems and assigns appropriate CDM's for ordered procedures, supplies and implants.
- Educates ancillary/clinical departments regarding charge selection for service provided.
- Assists with Supply Chain Management in determining appropriate charge for chargeable item.
- Two (2) years of experience in Chargemaster, Revenue Integrity, Auditing, Utilization Management, Coding, or Hospital Billing.
- Working knowledge of CPT, HCPCS Level II, Local Level III, and ICD10 coding and associated clinical expertise.
- Demonstrate a high level of critical thinking skills.
- Utilizes Excel for reports and data analyses.
- Strong verbal and written skills.
- Epic Resolute Hospital Billing.
- Competent with MS Office with strong emphasis/skilled on Excel.
- Charge Master maintenance in a multi-hospital system
- CPC, CCS, or relevant coding or auditing certification.
INDH
About the Company
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