Job Summary

Under the supervision of the Manager Medical Audit, the CDM Analyst is responsible for developing reports and tracking revenue activity and other analytics to identify opportunities, process improvements, and other system changes that will enhance revenue metrics. This role includes maintenance of revenue integrity through charge master files, fee schedules, and charge capture through annual updates, periodic audits, and ongoing review. Plans and performs ad hoc queries and analysis; assesses facility site needs to proactively provide service and support; analyzes the charge master and billing system to identify opportunities for optimal revenue capture and to incorporate standardized workflows; serves as a resource in developing and documenting routine custom billing system tests, builds, and enhancements that will improve maintenance and/or prevent billing errors; and performs lower complexity analysis and coordinates workflow implementations. Resource to clinical leaders to facilitate understanding and modification of item master and revenue trends for the clinical department. Under direction of leadership, the CDM Analyst works with the Revenue Cycle, Finance, and clinical departments to analyze coding and billing processes to ensure accurate and optimal revenue capture by developing trending, modeling, and other assessment tools. Responsible for leading a Revenue Cycle Committee made up of hospital managers to maximize revenue and decrease denials. Responsible to be the central point for receiving CMS bulletins and distributing them to the appropriate departments. Responsible for performing job duties in accordance with the mission, vision and values of Tampa General Hospital.

Qualifications

• A Bachelor's degree in business, healthcare administration or a related field with at least three (3) years of related experience or Associate's degree in business, healthcare administration or a related field with at least six (6) years of related experience is required.
• Ability to understand and analyze payor regulations and the impact to the charge master on reimbursement and coding guidelines.
• Ability to multi-task and work under aggressive deadlines.
• Possess effective time management skills to permit handling of a large workload. Knowledge of CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations and APCs.
• Ability to research complex coding and regulatory requirements.
• Strong analytical skills.