Job Description
Hospital billing at Solve IT Strategies, Inc. Hospital billing at Solve IT Strategies, Inc. in Stone Park, Illinois Posted in 1 day ago.
Type:
full-time Job Description:
CODING CERT REQUIRED
(CPC OR CCA) Revenue Integrity & Charge Description Master (CDM) Analys tThe Revenue Integrity & CDM Analyst is responsible for maintaining the accuracy, compliance, and integrity of Charge Description Master (CDM) systems and related revenue cycle processes. This role supports both facility and professional billing operations by ensuring accurate charge capture, pricing, coding alignment, and regulatory compliance. The analyst collaborates with clinical, operational, financial, and information technology teams to optimize revenue cycle performance, prevent revenue leakage, and support compliant billing practices .Key Responsibilitie sMaintain and manage Charge Description Master (CDM) records, including charge code additions, updates, deletions, and pricing revisions .Review and resolve charge review work queues, billing edits, and charging exceptions to support timely claim submission and reimbursement .Collaborate with information technology and operational teams to build, test, and implement charging workflows and system configurations .Analyze requests to ensure proper alignment of pricing methodologies, CPT/HCPCS coding, modifiers, revenue codes, and reimbursement requirements .Research and interpret Medicare, Medicaid, commercial payer regulations, and industry guidelines to maintain compliance and optimize reimbursement .Monitor revenue integrity metrics and identify opportunities to improve charge capture accuracy, operational efficiency, and financial performance .Support charge router logic, billing edits, and workflow enhancements to improve revenue cycle outcomes .Coordinate pricing updates, fee schedule maintenance, and reimbursement modeling activities .Develop and maintain policies, procedures, and documentation related to CDM governance and revenue integrity practices .Lead or participate in revenue cycle projects, regulatory initiatives, and system optimization efforts .Provide education and guidance to operational and clinical stakeholders regarding charging, coding, and compliance requirements .Utilize data analysis and reporting tools to identify trends, monitor performance, and support strategic decision-making .Ensure compliance with federal, state, and payer regulations while maintaining accurate billing practices .Qualification sSeveral years of healthcare revenue cycle experience in Revenue Integrity, Charge Description Master (CDM), Medical Coding, Billing, Reimbursement, or related healthcare finance functions .Strong knowledge of healthcare billing and reimbursement methodologies .Understanding of CPT, HCPCS
Level II, revenue codes, modifiers, and medical terminology .Experience working with electronic health record (EHR) systems and revenue cycle applications .Knowledge of payer regulations, compliance requirements, and healthcare reimbursement guidelines .Strong analytical, problem-solving, and project management skills .Excellent organizational, communication, and interpersonal abilities .Proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and reporting tools .Relevant coding, revenue cycle, or healthcare finance certifications preferred .Ability to manage multiple priorities and work effectively in a fast-paced healthcare environment .
