![]() ![]() Proactively monitor Local and National Coverage Determination (LCD, NCD) guidelines and transmittals. � Investigate CMS regulations, government coding requirements, IPPS/OPPS updates, NCCI edits, and managed care contracts for billing accuracy. � Monitor Gross Charge Revenue totaling $425M+ annually for various assigned clinical product/service lines throughout hospital system utilizing various reporting tools for the evaluation, research, and troubleshooting of issues. Analyze data within the Charge Description Master assigning accurate CPT/HCPCS, revenue codes, and modifiers to ensure compliance. � Share responsibility of managing the health system�s 222,000+ line item Charge Description Master (CDM) to ensure optimization in revenue generation while maintaining compliance with third-party payer requirements. �ĚCCELERATED BSN PROGRAM/GRADUATED REGISTERED NURSEīAYCARE HEALTH SYSTEM, CLEARWATER, FL, 2014-2019ĬHARGEMASTER COORDINATOR, REVENUE MANAGEMENT SERVICES (RMS)/CHARGE DESCRIPTION MASTER (CDM) � Monitor charge capture problem areas, and direct corrective actions to the staff. �Ědministrator for Craneware TRISUS Claims Informatics, Chargemaster toolkit, Online Reference Toolkit Applications ![]() �Ĝompleting Craneware Chargemaster audit. � Prepares clear and concise reports for senior leadership. � Review medical records and coding documents according to standard practice, using initiative and independent judgment within general policy guidelines. �Ĝollaborates with team to meet and complete the Price Transparency Requirements for Hospitals to Make Standard Charges Public Final Rule requirements. � Serves as liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build. �Ğnsures CPT, HCPCS and revenue codes are accurate and compliant with all charging and billing guidelines. � Identifies edits in patient management billing software that impacts billing accuracy. �Ĝreates action plans for capturing missed revenue. �Ĝonducts quality control audits and reviews charge capture clinical workflows for missed revenue opportunities. REVENUE INTEGRITY REGISTERED NURSE ANALYST/CHARGE DESCRIPTION MASTER (CDM) ![]() UNIVERSITY MEDICAL CENTER SOUTHERN NEVADA, LAS VEGAS, NV, 2020-PRESENT Research and Investigation ? Financial Assessment ? Revenue Cycle Integrity and Management ? Business Operations ? Continuous Process Improvement ? Leadership, Training, and Team Building ? Strategic Finance Planning and Implementation ? Time Management and Prioritization ? Problem Resolution ? Auditing ? Project Management ? Decision Making Exceptional ability to establish instant rapport with customers. Highly accomplished professional with the ability to manage an organization's daily operations, financial structure, and ongoing corporate strategy. Proficient at promptly responding to operational and financial challenges with confidence, determination, and focus. Coordinates successful tasks completion, combining implementation of strategic and collaborative operational initiatives that enhance financial performance and organizational growth. Analytical and detailed professional, with in-depth knowledge and expertise in finance, research, reports generation, data analysis, and troubleshooting within the healthcare revenue cycle. ![]()
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