Charge Integrity Coordinator
Requisition Number:
14842 Position Title:
External Description:
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.
Summary:
The Charge Description Master Coordinator will ensure the Supply CDM is accurate, up-to-date and compliant with all Federal and State Regulations.
Develops an annual CDM Supply reconciliation with Infor work plan.
All CDM change requests will be approved by the CDM Coordinator and reviewed for appropriateness and compliance with Payer and Regulatory Guidelines.
Will work closely with Purchasing, Supply chain, OR, IR and IC personnel to ensure all supplies are built accurately.
Responsible to educate all clinical departments on CDM change control, direct timely CPT/HCPC updates and correct charging protocols.
The CDM Supply Specialist will be the subject matter expert for all supply builds.
The Supply specialist will utilize all resources with an emphasis on HCPC and revenue code assignment for supplies.
Review and resolve claim edits on the EBEW and CEWL when the error is determined to be supply charge related.
Responsible to conduct root cause analysis and recommend solutions for corrective action plans.
Oversees the CDM scrubber software and develop the project plan to maintain implementation of the tool.
Responsible for maintaining the Supply Level Grid mapping, the Infor reconciliation process for East and West.
Manages the yearly Supply CDM reviews and ensures all OPPS quarterly updates are added to the CDM timely.
Pays special attention to all HCPC updates for supplies and device dependent CDMs.
Responsibilities:
Confers with representatives from departments to identify current and projected business objectives, applying technical and business knowledge to provide guidance and recommendations for solutions to business problems or system enhancements.
(Designs explode code sets, workflows for charging and billing) (Charge triggers).
Develops and monitors quality indicators to ensure consistency and quality of service.
(Such as daily revenue reports and charge baseline reports) Cultivates strong relationships within the CIG department, customer (business users), and vendors.
(Vizient, Infor, Vitalware,Nthrive) Performs ITG functions as they relate to the charge description master such as report extracts and spreadsheet uploads (prepares data staging spreadsheet) Utilizes the SMART data sheets for Purchasing.
Runs CEWL daily report out of SF, Prepares extract file for monthly upload onto WCHN website.
Trains departments and utilizes business intelligence reports such as Tableau for all revenue generating clinical departments.
Acts as consultant to service lines and business units regarding business practices and system requirements for Soarian Financials system build (service mapping, price list linking, Charge entry indicators and service provider linking).
Builds SPSID codes, tests all charges and ensures interfaces between systems are working as designed.
Maps and maintains a crosswalk for Supply CDMs to the appropriate Level for charging.
I.
E Catheter Level 4.
Analyzes, assigns and resolves charge edits on the EBEW and CEWL, recommends corrective actions.
Coordinates with ITG and clinical departments to implement corrective actions.
Initiates quarterly and Annual CPT/HCPC updates in accordance with published guidelines from AMA, CMS, develops a project plan to review each clinical area CDM and updates on a scheduled basis.
Reviews the end-to-end process for the charge trigger and includes all departments that will be impacted by CDM code changes across the network well in advance of the changes.
Directs all on -going CDM related training and education to hospital revenue departments and maintains CDM Change Control.
Provides remediation training as needed.
Presents materials and prepares power point presentations for meetings and educational sessions.
Coordinates, monitors and approves all changes to the CDM Change Control process, assigns the appropriate revenue code for supply billing, reviews pricing methodology and correct wRVU assignment for Medical Groups.
Provides training and guidance on technical and regulatory matters to the CI Specialist.
Requirements:
Bachelors degree (in business or finance and minimum 3 years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience.
OR Associate Degree (business or finance and minimum 5 years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience.
OR A minimum of 7 years of hospital, clinic setting or insurance company with revenue cycle and or revenue integrity experience.
Strongly preferred- experience in Supply chain and purchasing.
What We Offer:
Medical, Dental, Vision Paid Time Off (PTO) 401K Life and Disability Tuition Reimbursement In addition, we provide a range of voluntary benefits!! Location:
Summit-100 Reserve Rd Work Type:
Full-Time Standard Hours:
40.
00 Work Schedule:
DAY SHIFT Pay Range:
$32 to $42 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.
City:
Danbury State:
Connecticut Community / Marketing Title:
Charge Integrity Coordinator Company Profile:
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 Yorks Hudson Valley and western Connecticut with more convenient, accessible and affordable care.
EEO Employer Verbiage:
Location_formattedLocationLong:
Danbury, Connecticut US Job Number:
45022 Recommended Skills Billing Business Ethics Business Intelligence Business Planning Chargemaster Clinical Works Estimated Salary: $20 to $28 per hour based on qualifications.
14842 Position Title:
External Description:
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.
Summary:
The Charge Description Master Coordinator will ensure the Supply CDM is accurate, up-to-date and compliant with all Federal and State Regulations.
Develops an annual CDM Supply reconciliation with Infor work plan.
All CDM change requests will be approved by the CDM Coordinator and reviewed for appropriateness and compliance with Payer and Regulatory Guidelines.
Will work closely with Purchasing, Supply chain, OR, IR and IC personnel to ensure all supplies are built accurately.
Responsible to educate all clinical departments on CDM change control, direct timely CPT/HCPC updates and correct charging protocols.
The CDM Supply Specialist will be the subject matter expert for all supply builds.
The Supply specialist will utilize all resources with an emphasis on HCPC and revenue code assignment for supplies.
Review and resolve claim edits on the EBEW and CEWL when the error is determined to be supply charge related.
Responsible to conduct root cause analysis and recommend solutions for corrective action plans.
Oversees the CDM scrubber software and develop the project plan to maintain implementation of the tool.
Responsible for maintaining the Supply Level Grid mapping, the Infor reconciliation process for East and West.
Manages the yearly Supply CDM reviews and ensures all OPPS quarterly updates are added to the CDM timely.
Pays special attention to all HCPC updates for supplies and device dependent CDMs.
Responsibilities:
Confers with representatives from departments to identify current and projected business objectives, applying technical and business knowledge to provide guidance and recommendations for solutions to business problems or system enhancements.
(Designs explode code sets, workflows for charging and billing) (Charge triggers).
Develops and monitors quality indicators to ensure consistency and quality of service.
(Such as daily revenue reports and charge baseline reports) Cultivates strong relationships within the CIG department, customer (business users), and vendors.
(Vizient, Infor, Vitalware,Nthrive) Performs ITG functions as they relate to the charge description master such as report extracts and spreadsheet uploads (prepares data staging spreadsheet) Utilizes the SMART data sheets for Purchasing.
Runs CEWL daily report out of SF, Prepares extract file for monthly upload onto WCHN website.
Trains departments and utilizes business intelligence reports such as Tableau for all revenue generating clinical departments.
Acts as consultant to service lines and business units regarding business practices and system requirements for Soarian Financials system build (service mapping, price list linking, Charge entry indicators and service provider linking).
Builds SPSID codes, tests all charges and ensures interfaces between systems are working as designed.
Maps and maintains a crosswalk for Supply CDMs to the appropriate Level for charging.
I.
E Catheter Level 4.
Analyzes, assigns and resolves charge edits on the EBEW and CEWL, recommends corrective actions.
Coordinates with ITG and clinical departments to implement corrective actions.
Initiates quarterly and Annual CPT/HCPC updates in accordance with published guidelines from AMA, CMS, develops a project plan to review each clinical area CDM and updates on a scheduled basis.
Reviews the end-to-end process for the charge trigger and includes all departments that will be impacted by CDM code changes across the network well in advance of the changes.
Directs all on -going CDM related training and education to hospital revenue departments and maintains CDM Change Control.
Provides remediation training as needed.
Presents materials and prepares power point presentations for meetings and educational sessions.
Coordinates, monitors and approves all changes to the CDM Change Control process, assigns the appropriate revenue code for supply billing, reviews pricing methodology and correct wRVU assignment for Medical Groups.
Provides training and guidance on technical and regulatory matters to the CI Specialist.
Requirements:
Bachelors degree (in business or finance and minimum 3 years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience.
OR Associate Degree (business or finance and minimum 5 years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience.
OR A minimum of 7 years of hospital, clinic setting or insurance company with revenue cycle and or revenue integrity experience.
Strongly preferred- experience in Supply chain and purchasing.
What We Offer:
Medical, Dental, Vision Paid Time Off (PTO) 401K Life and Disability Tuition Reimbursement In addition, we provide a range of voluntary benefits!! Location:
Summit-100 Reserve Rd Work Type:
Full-Time Standard Hours:
40.
00 Work Schedule:
DAY SHIFT Pay Range:
$32 to $42 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.
City:
Danbury State:
Connecticut Community / Marketing Title:
Charge Integrity Coordinator Company Profile:
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 Yorks Hudson Valley and western Connecticut with more convenient, accessible and affordable care.
EEO Employer Verbiage:
Location_formattedLocationLong:
Danbury, Connecticut US Job Number:
45022 Recommended Skills Billing Business Ethics Business Intelligence Business Planning Chargemaster Clinical Works Estimated Salary: $20 to $28 per hour based on qualifications.
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