5+ years of experience
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Employment Type:
Full time
Job Category:
Health Care Provider
Health Care & Medicine
Manager, Charge Description Master (CDM) & Charge Capture
Children's National Health System | Silver Spring, Maryland
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Job Description


 Minimum Education
Bachelor's Degree

Specific Requirements and Preferences
Bachelor’s Degree in Business Administration, Hospital Administration, Public Administration or other related field. Master’s Degree in Business Administration, Hospital Administration, Public Administration or other related field preferred.

Minimum Work Experience
5 Year(s)

Specific Requirements and Preferences
At least 5 years of minimum recent experience in the healthcare industry is required in the follow areas: CDM management (Physician or Technical); CDM tool application (e.g., MedAsset, Craneware); Coding and billing requirements from third party payers; CMS regulatory coding and billing guidelines. Implemented charge capture initiative for both Physician and Technical services. Familiar with various KPIs.

Required Skills/Knowledge
Cerner’s ancillary systems (e.g., RIS, PharmaNet, SurgiNet). Computerized Physician Order Entry (CPOE) knowledge. Ability to quantify opportunities and the corresponding ROI. Sufficient clinical and coding knowledge design required process changes and benefits. Excellent in data analytics and industry trending in data comparative analysis. Knowledge of ICD-10.

Required Licenses and Certifications
Coding Certification, preferred.

Functional Accountabilities

Program Administration
  1. Maintain an accurate CDM that will allow accurate billing of both CMS and third-party payers through analysis and verification of charging procedures while ensuring correctness of coding and charge structure in the CDM.
  2. Implement standardized CDM update processes and controls to facilitate timely CDM updates and related activities (e.g., communication to clinical staff, education, IT charge screen and charge ticket form updates).
  3. Assist clinical department managers in the preparation and review of all requests for additions and revisions to the CDM for completeness and accuracy, with special attention on both annual and routine HCPCS updates.
  4. Communicate complex issues and changes related to regulatory compliance and third-party reimbursement to the department(s) involved, while maintaining records of their notification, accountability and compliance.
  5. Provide essential quality evaluation, reports, advice and improvement recommendations to management in all service lines.
  6. Review local, state and government regulations to ensure ongoing compliance.
  7. Review with departments any issues which may lead to non-compliance or reduced reimbursement.
  8. Provide charge capture training to ensure all processes, both manual and electronic, are updated and that quality assurance methods are in place to capture all daily charges.
  9. Perform random and focused audits of patient accounts using medical records, claims (UB-04,itemized bill, 1500) and remittances for potential charging issues, to verify the accuracy of both Physician and Technical submitted charges, missing charges and lost revenue opportunities.
  10. Provide departmental support for special projects related to revenue enhancement.
  11. Seek out, identify and communicate revenue enhancement opportunities.
  12. Respond promptly to inquiries, concerns and problems related to revenue integrity.
Human Resources
  1. Collaborate with clinical stakeholders, Patient Financial Services (PFS) and Coding to ensure proper CDM updates are maintained and the allied systems are in sync.
  2. Coordinate with clinical department, Finance, PFS, and IT the development of the CDM for all new services as well as updates to existing services.
  3. Act as a resource for all staff on items related to revenue integrity.
Information Resources Management
  1. Work with departmental contacts and IT representatives to ensure the hospital’s ancillary systems (e.g., RIS, PharmaNet, SurgiNet) and CDM are in sync.
  2. Assist in the installation of all department Clinical Information Systems that interface with CNMC billing systems to ensure revenue integrity.
  3. Actively lead and participate in upgrade testing and implementation of new systems.

About Children's National Health System

Childrens National Medical Center is the only exclusive provider of pediatric care in the metropolitan Washington area and is the only freestanding childrens hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta. Serving the nations children for more than 130 years, Childrens National is a proven leader in the development and application of innovative new treatments for childhood illness and injury.

Childrens National is proudly ranked consistently among the best pediatric hospitals in America by US News & World Report.

Our Culture

Children's mission is to be preeminent in providing pediatric health care services that enhance the health and well-being of children regionally, nationally and internationally. Through leadership and innovation, Children's creates solutions to pediatric healthcare problems. Children's excels in Care, Advocacy, Research, and Education to meet the unique needs of children, adolescents and their families. Children's leadership realizes that our employees are the heart of our medical center and the soul of our mission. One of our greatest assets is the diversity of our workforce, which adds to the richness of our culture. Teamwork, dedication, and professionalism are essential values and characteristics that make our employees unique.

Childrens internationally recognized team of pediatric healthcare professionals care for more than 360,000 patients each year who come from throughout the region, nation and world. Our employees share a sense of pride and commitment to the patients and families we serve. We aspire to provide patients and their families with the highest quality of care and service in a family-centered environment. In essence, we are a team of "Great People Providing Great Care."

Nursing Students

As a nursing student, you might already be craving hands-on experience at a highly respected hospital. You may be thinking about where or with which population you want to work after graduation.

At Childrens, a world-class teaching hospital and internationally-recognized leader in pediatric health, we invite nursing students at all stages of learning to explore the real world of working in a hospital setting and experience first-hand the challenges and rewards of this career.

Internship Program

The internship program provides the novice nurse with the knowledge base and skill set needed to transition to competence in clinical nursing practice. While providing the needed skills to meet the organization goals and mission, the program provides nurses with the leadership skills to work collaboratively within a multidisciplinary team. The program bridges the gap between undergraduate education and real-life professional nursing practice, delivering state-of-the art pediatric care.

The program is offered to new graduate nurses from an accredited nursing program with a passion for children. All new graduates, with less than one-year acute care experience, are eligible to participate in the program after obtaining licensure.