Health Care District of Palm Beach County

This position is responsible for managing, coordinating, and implementing Charge Description Master (“CDM”) initiatives and processes. Ensures the overall integrity of the CDM. Maintains the CDM with a focus on accuracy, revenue cycle integrity, and compliance with third-party payor requirements. Assists departments with charge capture, billing, and compliance issues in accordance with government regulations. Facilitates maintenance of the CDM through additions, deletions, or modifications to line-item charges. Works independently; exercises discretion and independent judgment; makes decisions regarding the CDM after comparing and evaluating possible courses of action; formulates, affects, interprets, and implements management policies and operating practices; prioritizes and manages multiple tasks to meet deadlines; seeks guidance from management as needed to clarify assignments or requests, ask questions, or seek additional information.

Essential Functions:

• Reviews CDM change requests for accuracy and appropriateness; approves additions, deletions, and modifications to charges; imparts knowledge to facilities regarding requested changes
• Identifies, researches, analyzes, review/analysis of pricing, resolves, and monitors CDM and charge capture processes to promote appropriate and consistent billing and coding practices.
• Provides guidance, communication, and education to multiple levels of personnel on correct billing, coding, and charge capture processes for hospital services and community health centers.
• Assists with special projects related to price increases, special requests from departments, system conversions, or implementation of new CDM tools. May include other duties and/or special projects not listed.
• Assists in training new staff. Assists in coaching existing staff by building or enhancing individual skills or deficiencies.

Education:

• High School graduate or equivalent required.
• College degree preferred.

Experience:

• 3-5 years of healthcare-related experience.

Certification/ License:

• Applicable clinical or professional certifications and licenses such as, COC, CPC, CCS required.

Knowledge, Skills, and Abilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required.

• Working knowledge of the accepted principles, practices and tools relating to general healthcare billing, and reimbursement.
• Working knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting, documentation and general compliance.
• Working knowledge of the content and application of published health information management coding conventions, e.g., as referenced in "Coding Clinics" and/or other nationally recognized coding guidelines.
• Working knowledge of CMS guidelines
• Ability to recognize, research and correct charging/documentation discrepancies.
• Working knowledge of the standards and regulatory requirements applicable to matters within designated scope of authority, including medical/legal issues.
• Working knowledge of medical terminology and abbreviations, and health care nomenclature and systems.
• Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency.
• Ability to establish and maintain effective working relationships as required by the duties of the position.
• Working knowledge of CPT/HCPCS codes, revenue codes, CCI edits
• Coding experience for Hospital and Professional
• Ability to interpret a variety of state and federal regulations and determine affect on CDM and claims production

The Health Care District of Palm Beach County is an independent special taxing district that has served as a healthcare safety net for more than 36 years to fill in gaps in access to healthcare services. This unique healthcare system covers the entire county and provides a wide range of services such as nine community health centers (Federally Qualified Health Centers) which serve everyone regardless of ability to pay; school health teams in 172 public schools; a lifesaving Trauma Hawk aeromedical helicopter program; a rural, public teaching hospital, Lakeside Medical Center; an award-winning skilled nursing center; a ground ambulance program for Health Care District patients needing a higher level of care and the county’s Trauma Agency, which ensures quality outcomes within the county’s trauma system and leads initiatives to prevent traumatic injury.

We are committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin or ancestry, sex, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, marital status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.

We are also committed to maintaining a safe, healthy, and productive work environment for all employees. As such, we are a Drug-Free Workplace.

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