Director of Charge Description Master CDM Clinical Auditing - Patient Accounting Billing Unit
Director of Charge Description Master CDM Clinical Auditing - Patient Accounting Billing Unit
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Job Description
ABOUT THE POSITION
The County of Riversides Patient Accounting and Billing Unit at Riverside University Health System (RUHS) Mission Grove location is seeking a Director of Charge Description & Clinical Auditing to join our team in Riverside.
The Director of Charge Description & Clinical Auditing will be responsible for managing and optimizing the standard Charge Description Master (CDM) to ensure it is accurate and compliant with coding rules and billing regulations. This position will lead the departments efforts in reviewing and researching chargerelated data to maintain compliance and accuracy within the systems CDM. The Director will ensure that CDM maintenance requests are processed and completed efficiently accurately and in a timely manner.
Additionally the Director will collaborate with RUHS stakeholders to identify chargerelated opportunities evaluate current procedures and assess internal controls to ensure charge master code compliance charge accuracy and improved charge capture. The role also includes maintaining oversight of the departments documentation of policies and procedures ensuring compliant billing practices and educating department staff and other stakeholders on CDM maintenance processes and compliance.
Desired Qualifications:
- A Masters degree in Healthcare Administration Business or a related field
- At least one 1 year of handson experience with Charge Description Master (CDM) management including auditing adding deleting updating cash pricing and OSHPD reporting.
- Proven experience in clinical audits including auditing billing charges and handling clinical payer appeals in a hospital environment.
- Clinical experience as an LVN or RN is preferred
- Professionallevel experience with EPIC
- Advanced proficiency with Microsoft Excel including data analysis and report generation.
- Bilingual skills in English and Spanish preferred.
Work Schedule:
9/80 Friday Day Shift
This position is strictly onsite with no remote work options. The first 30 days of training will follow a 5/8 schedule.
Meet the Team!
Riverside University Health System (RUHS)
The classification for this position is Director of Patient Business Services; however the working title is Director of Charge Description & Clinical Auditing. This is a continuous posting and will remain up until the position is filled. Applications will be reviewed and competitive candidates will be referred for interviews in the order in which they are received.
This class has been designated AtWill by the Board of Supervisors in accordance with the provisions provided under Article 6 Section 601E 8 of the County Management Resolution and serves at the pleasure of the Assistant County Executive OfficerHealth System.
This class has been deemed eligible for the Performance Recognition Plan as set forth under Article 3 Section 311(C) of the County Management Resolution. Program eligibility requires employees to be in a leadership position manage other employees or programs and have significant influence on the achievement of organizational objectives.EXAMPLES OF ESSENTIAL DUTIES
- Responsible for oversight and management of CDM team.
- Responsible for developing and maintaining the Charge Master standard.
- Ensures that the RUHS system standard Charge Master meets federal state regulatory requirements and guidelines and adheres to RUHS policies.
- Works with departments to ensure that the Charge Master accurately reflects the services provided by the clinical departments.
- Responsible for periodic reviews of all hospital charges to ensure that all charges are in compliance with RUHS system standard Charge Master.
- Responsible for routinely communicating the status of CDM integrity and accuracy to key stakeholders; notifies stakeholders as appropriate when issues arise.
- Provides reports and other documents as required to measure compliance to the standardized CDM.
- Develop Policies and Procedures for maintaining the RUHS standard CDM incorporating the RUHS CDM Guiding Principles and Charge Policies.
- Evaluates the efficiency or adequacy of Charge Master related processes and leads the development of new procedures as appropriate.
- Builds and maintains effective working relationships with other departments (Epic IS HIM/Coding Compliance Patient Access Clinical depts. etc.
- Responsible for implementing routine standardized reporting to provide stakeholders with commonly requested CDM extracts Revenue and Usage etc.
- Serves as Charge master expert for executives and Revenue Cycle pillar leaders; and provides support to CDM team Revenue Cycle and hospital stakeholders.
- Consults with internal and external customers on the development and implementation of projects and process improvement.
- Maintains communication with all stakeholders to ensure efficient operations and successful implementations; including management of customer satisfaction and expectations.
MINIMUM QUALIFICATIONS
- Education: Graduation from an accredited college or university with a Bachelors degree with major coursework in business public healthcare or hospital administration or other field closely related to patient business services. (Additional qualifying experience may substitute for the required education on the basis of 30 semester or 45 quarter units equaling one year of fulltime experience.
Experience: Three years of supervisory experience which included responsibility for revenue cycle activities in a hospital or healthcare organization. SUPPLEMENTAL INFORMATION
For questions regarding this recruitment please contact the recruiter Jill Eastman at
APPLICATION INFORMATION
Veterans Preference
The County has a Veterans Preference Policy applicable to new hires. To qualify upload a copy of your (or your spouses) Member4 Form DD214 indicating dates of service and a copy of your spouses letter of disability (if applicable) with your application. For privacy reasons it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans Veterans Preference Policy C3 is available here: https://rivcocob/boardpoliciesReasonable Accommodations
The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation please visit the Disability Access Office web page located at: https://rchr/disabilityProof of Education
If using education to qualify or when requested by the recruiter upload a copy of any license(s) official/unofficial transcript(s) degrees and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.If your education was completed outside of the United States you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services NACES or Association of International Credential Evaluators Inc. AICE.
Equal Opportunity Employer
The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race color religion sex national origin age disability sexual orientation gender gender identity gender expression marital status ancestry medical condition (cancer and genetic characteristics) genetic information or denial of medical and family care leave or any other nonjobrelated factors.PreEmployment
All employment offers are contingent upon successful completion of preemployment requirements including a criminal background investigation which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A preemployment physical examination and background check may be required.Probationary Period
As an Approved Local Merit System all County of Riverside employees except those serving At Will are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding County Resolution or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.General Information
Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.
Please read and follow any special application instructions on this posting. Click the Apply link located on this page to submit your application. For additional instructions on the application process examinations Veterans preference preemployment accommodation or other employment questions please refer to our web site .
If you are experiencing technical problems you may contact the governmentjobs applicant support desk Monday through Friday 6 am to 5 pm Pacific Time at or tollfree.
Required Experience:
Director
Employment Type
Full-Time
