Experience

PARA Healthcare Financial Services

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Charge Description Master Client Manager

  • May 2013 - Present

  - Audits CDM items supporting reimbursement for outpatient hospital and professional services and serves as client liaison for implementation of recommended changes - Conducts CDM reviews, necessary client education & charge capture assessments, typically over web meetings - Uses proprietary software to research client questions, develop standardized reports, and communicate findings back to the client - Assists in preparing, transmitting and developing action plan for client implementation of CMS quarterly and annual updates Show less



NorthShore University HealthSystem

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Senior Chargemaster Analyst

  • Jul 2006 - May 2012

  • Continually managed the maintenance of the corporate charge description master for assigned departments in four main hospitals and medical group • Researched and coordinated updates in the billing and charge entry systems with any CPT, pricing, description, and revenue code changes in the charge description master as well as all associated sub-systems • Conducted periodic audits of hospital ancillary departments’ charge description masters & charge entry screens • Implemented annual updates to the CDM as affected by the AMA CPT-HCPCS code changes at the beginning of each calendar year, and conducted a fee schedule review to insure pricing was in line with reimbursement updates. • Participated in annual fiscal year hospital pricing review based on hospital pricing methodologies, hospital contractuals & consumer-driven services • Conducted annual medical group physician pricing review based on various medical group pricing methodologies, provider-based billing practices, and medical group physician contractuals • Proactively analyzed and applied government regulatory changes related to service/supply reimbursements and/or the CDM management and claims submission for all clinical specialties • Performed daily hospital account & medical record reviews in conjunction with the hospital billing department for identification and corrections of accounts on hold due to charges pending in system workqueues for place of service errors, inaccurate charge selection, incorrect cost center assignment, etc. Show less



Rush University Medical Center

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Cycle Analyst

  • Jul 2005 - Jul 2006

  • Assisted the Revenue Management Director in Revenue Cycle and Financial Operations projects.• Participated in the design and build decisions, necessary to implement the new EPIC patient management system through the Charge Capture EPIC Implementation Committee and the EPIC Master File Planning Committee.• Assessed the impact of revenue management initiatives through assistance with charge capture, CDM and denial management audits and related departmental communications and interventions.• Served as point of contact person for the fiscal year hospital pricing and rate modeling project conducted annually by the Med Assets consulting team; Acted as a liaison between consultants, ancillary departments, hospital Finance and Budgeting, to help roll out pricing recommendations within the given budgetary timeframes.• Utilized the Med Assets best practice module and Code Correct software to resolve and reduce billing errors.• Utilized the Med Assets comparative rate modeling module to identify and resolve pricing issues.• Provided education and training to clinical departments regarding CDM ownership and maintenance, and assisted in the creation/maintenance of departmental charge tickets.• Created and maintained written policies and procedures related to revenue cycle and process improvement.• Created and formatted reports using Express Query Writing Tool, to review and resolve patient financial account problems contributing to revenue cycle obstacles. Show less

• Chargemaster Coordinator

  • Dec 2002 - Jul 2005

  • Implemented continual development, maintenance, and audit functions of the hospital Charge Description Master.• Researched and maintained familiarity with Medicare billing regulations and CPT/HCPCS/revenue code guidelines and implemented all necessary revisions for maximum hospital reimbursement.• Assisted in the implementation and maintenance of Code Correct and Med Assets Revenue Systems tools, acting as a communicator between the departments and software support; including recurring monthly hospital data submissions, departmental training and user sign-on assignment.• Manually entered specific charge description requests into the Patient Charging/Accounting systems and communicated with the hospital administrators affected.• Worked closely with ancillary departments to maintain pricing consistency in CDM line items, audit CPT/HCPCS codes and ensure revenue code compatibility for accurate billing detail, and federal and state compliance regulations.• Monitored and tracked bill holds in the Billing Exceptions Unit to resolve any coding errors as necessary, to get bills released.• Worked in conjunction with hospital internal audit, corporate compliance, billers, and collectors to obtain resolution of CDM issues by running reports and providing analysis. Show less