RCMI Charge Description Master (CDM) Senior Solution Technical Expert (SSTE)

Great Hill Solutions, LLC is part of the Seneca Nation Group (SNG) portfolio of companies. SNG is Seneca Holdings' federal government contracting business that meets mission-critical needs of federal civilian, defense, and intelligence community customers. Our portfolio comprises multiple subsidiaries that participate in the Small Business Administration 8(a) program. To learn more about SNG, visit the website and follow us on LinkedIn.

Our team of talented individuals is what makes us successful. To support our team, we provide a balanced mix of benefits and programs. Your total rewards package includes competitive pay, benefits, and perks, flexible work-life balance, professional development opportunities, and performance and recognition programs. We offer a comprehensive benefits package that includes medical, dental, vision, life, and disability, voluntary benefit programs (critical illness, hospital, and accident), health savings and flexible spending accounts, and retirement 401K plan. One of our fundamental principles is to offer competitive health and welfare benefits to our team members, providing coverage and care for you and your family. Full-time employees working at least 30 hours a week on a regular basis are eligible to participate in our benefits and paid leave programs. We pride ourselves on our collaborative work environment and culture, which embraces our mission of providing financial and non-financial benefits back to the members of the Seneca Nation.

Great Hill is seeking a RCMI Charge Description Master (CDM) Senior Solution Technical Expert (SSTE) in the continental US to support the Defense Health Agency. The objective of this work is to support the DHA Financial Operations, J-8 with capabilities for optimization of revenue cycle efforts to prioritize improvement opportunities, begin reducing work queue backlog in MHS GENESIS, increase clinical workload capture, increase total billed for Third Party Collections (TPC), identify and correct areas where revenue leakage may be occurring, improve enterprise knowledge of workload and revenue capture, and enhance MTF staffs' ability to manage their business and be audit-ready. assist our government healthcare client to optimize Revenue Cycle operations.

Roles and Responsibilities include, but are not limited to:

• Possess skill sets to flawlessly build, maintain, and sustain the master CDM using technology of the governments choice, and ability to remain current with all regulatory changes resulting in code additions, deletions, and modifications.
• Provide education regarding charge input and charge master related items to MHS Business Community personnel.
• Advise the RCM stakeholders on CDM policy and practices to ensure regulatory compliance.
• Professionally interact with identified RCM functional stakeholders within and outside the J8 Directorate to seamlessly implement CDM resolutions to existing and/or future issues or requirement enhancements/optimizations.
• Maintain continuous updates of CDM based on American Medical Association (AMA) and Centers for Medicare and Medicaid (CMS) regulatory releases and Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) revisions.
• Coordinate CPT/HCPCS cost-based price reviews with DHA Uniform Business Office as codes are added, deleted, or modified based on CMS regulatory reports.
• Document and maintain CDM Standard Operating Procedure (SOP) manual and other training materials/user guides with current CDM workflow, pricing guidelines, and validation steps for existing, new, or unique, MHS code descriptions, revenue codes, surgical levels, clinical areas, and other data components, no less than once per quarter based on regulatory updates. In some cases, the CDM SOP may require ad hoc updates if emergency codes are released off cycle.
• Support MHS-specific CDM modifications, additions, and deletions as requested by the DHA or MHS GENESIS client.
• Develop and continually refine a supply item file to serve as the source file for all chargeable supply items, no less than once per quarter.
• Continue to coordinate maintenance of the CHAMPUS Maximum Allowable Charge (CMAC) rate tables within the CDM based on DHA UBO calculated rates using annual Tricare data releases and existing MHS rate structures; along with additional rate tables/prices scheduled required.
• Coordinate utilization of updates to Medical Expense and Performance Reporting System (MEPRS), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Defense Medical Logistics Standard Support (DMLSS), and CHAMPUS Maximum Allowable Charge (CMAC) data sources as defined co