Charge Description Master Technician - Revenue Integrity; DH

Overview

Navajo Preference Employment Act
In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.

The primary responsibility of the Charge Description Master Technician (CDMT) is the Hospital and Ambulatory Clinics charge master maintenance. The charge master maintenance is a continuous process that ensures all services are accurately charged and that the hospital and ambulatory clinics are compliant with government regulations for pricing and provides assurance that the organization receives accurate reimbursement. The CDMT must work with service area leaders and providers along with the Coding Supervisor to assure correct service item service code selection and charging of services.

The CDMT must have mathematical skills and apply the appropriate pricing policy to each of the hospital and ambulatory clinic service items. Responsibilities will also include coordination of Charge Description Master tasks with the Revenue Integrity Coordinator for the purpose of two-way communication to the Clinical Service Leaders. The CDMT will provide assistance to the Director of Revenue and Reimbursement as applicable.

Education: Must have High School Diploma or GED

Experience:

• Minimum two-year experience in financial or clinical service areas.
• Minimum one-year experience as a patient access specialist, client service technician, medical billing, accounts receivable technician in a tribal or non-profit healthcare patient accounting setting, or medical coder. Experience as an LPN or RN may substitute patient access specialist, client service technician, medical billing, accounts receivable, or Medical coder.
• Demonstrated knowledge of ICD-9 and ICD-10, and CPT/HCPCS coding/billing procedures, Uniform Hospital Discharge Data definitions regarding diagnostic and procedural sequencing in order to interpret and resolve problems based on information derived from system monitoring reports and the UB-04, HCFA-1500, and ADA billing forms submitted to the third-party payer
• Computer skills; ability to access and use multiple data systems.

Other

Skills and Abilities:

• A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each of the areas listed below.
• Positive working relationships with others
• Knowledge of team dynamics and the process of building consensus.
• Detailed knowledge of various third-party payment systems.
• Skill in using personal computers for financial analysis (spreadsheets).
• Skill in performing research with bibliographic data bases and Internet access to associated information resources.
• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences and no reported attendance issues
• Ability to plan and lead effective team meetings and training
• Possess expertise in professional communication, interpersonal, organizational leadership and team building skills
• Possess excellent customer services skills for internal and external customers
• Ability to work under pressure and making quality and effective decisions
• Ability to positively motivate individuals and teams to meet or exceed department expectations/goals.
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC.

The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential…