Own epic cdm integrity and maintenance, including charge codes, descriptions, cpt/hcpcs assignments, revenue codes, modifiers, units of service, pricing, and effective dates.
Manage charging configuration and workflows, including charge routing, triggers, order-entry linkages, charge sets, procedure records, and department/cost-center mappings.
Oversee revenue integrity and charge work queues, identifying missing, duplicate, high-dollar, unusual, or incorrectly generated charges and resolve root causes before claims submission.
Provide department education and accountability, training clinical teams on charge capture and reconciliation while establishing charge champions and monitoring departmental compliance.
Perform auditing and compliance activities, validating that services are appropriately documented, charged, coded, and reimbursed, while supporting payer audits and regulatory requirements.
Lead new service, regulatory, and pricing changes, including cpt/hcpcs updates, annual pricing, new services and technology, and analysis of medicare/medicaid and payer reimbursement impacts.
Analyze reimbursement and revenue impact, identify charging gaps, underpayments, reimbursement variances, and opportunities to improve pricing, margins, and revenue capture.