Job Description

University of Utah Job Description

Job Summary

Qualifications

Basic computer skills, i.e., word processing, spreadsheets and menu-driven software, are preferred.

This position has no responsibility for providing care to patients.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Disclaimer

This job description has been designed to indicate the general nature and level of work performed by employees within this classification.  It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Essential Functions

1. Maintains the CDM by incorporating new charges/services identified by the departments, third party changes, HCFA special requirements, and coding updates.
2. Performs a detailed, annual review of the CDM which includes identifying CPT and HCPCS Level II codes which have been deleted, added or replaced; assigning CPT and HCPCS specific codes when appropriate; identifying description changes; and ensuring the nomenclature reflects the procedures performed.
3. Identifies services that are reimbursable but are not being coded; reviews, assigns, and validates revenue codes.
4. Coordinates annual and bi-annual meetings with department managers, staff and/or physicians regarding new program and procedure developments, equipment acquisitions and validation of inactive codes.
5. Determines charge and charge attributes for new services and products.
6. Communicates CDM changes to the hospital departments and administration, patient accounting and others who are impacted by the change.
7. Maintains audit trail of CDM changes.
8. Distributes correspondence of third-party requirements for coding changes to departments for review of the impending changes.
9. Researches and resolves CPT code, revenue code and other issues referred by the Patient Accounting department.
10. Utilizes strategic pricing applications to maximize payments within the hospital budget requirements.
11. Utilizes third party payors and local Fiscal Intermediary as a technical resource.
12. Establishes and maintains positive working relationships with medical directors, department chairs and principal investigators.
13. Serves as a resource to hospital departments, i.e., assists with the start-up process for new programs, answers implementation questions.
14. Completes and provides management reports as requested.

    Problem Solving

    The incumbent has the authority to develop and implement methodology and procedures to meet departmental goals and objectives.

    Challenges encountered by the incumbent includes ensuring the accuracy of pricing structures and codes as required by local, state and federal regulations. The incumbent must maintain current knowledge of market changes and develop and incorporate these changes into market sensitive procedures.

    Other challenges include serving as liaison for medical directors, department chairs and principal investigators in developing and implementing new programs to ensure hospital-wide uniformity of charges and coding for similar products and procedures.