Director of Charge Description Master (CDM) & Clinical Auditing - Patient Accounting & Billing Unit

About The Position

The County of Riverside's Patient Accounting and Billing Unit at Riverside University Health System (RUHS) Mission Grove location is seeking a Director of Charge Description & Clinical Auditing to join our team in Riverside. The Director of Charge Description & Clinical Auditing will be responsible for managing and optimizing the standard Charge Description Master (CDM) to ensure it is accurate and compliant with coding rules and billing regulations. This position will lead the department’s efforts in reviewing and researching charge-related data to maintain compliance and accuracy within the system's CDM.

Responsibilities

• Manage and optimize the standard Charge Description Master (CDM) to ensure it is accurate and compliant with coding rules and billing regulations.
• Lead the department’s efforts in reviewing and researching charge-related data to maintain compliance and accuracy within the system's CDM.
• Ensure that CDM maintenance requests are processed and completed efficiently, accurately, and in a timely manner.
• Collaborate with RUHS stakeholders to identify charge-related opportunities, evaluate current procedures, and assess internal controls to ensure charge master code compliance, charge accuracy, and improved charge capture.

Requirements

• A Master's degree in Healthcare Administration, Business, or a related field.
• At least one (1) year of hands-on experience with Charge Description Master (CDM) management, including auditing, adding, deleting, updating, cash pricing, and OSHPD reporting.
• Proven experience in clinical audits, including auditing billing charges and handling clinical payer appeals in a hospital environment.
• Clinical experience as an LVN or RN is preferred.
• Professional-level experience with EPIC.
• Advanced proficiency with Microsoft Excel, including data analysis and report generation.
• Bilingual skills in English and Spanish preferred.

Qualifications

• Education: Graduation from an accredited college or university with a Bachelor's degree with major coursework in business, public, healthcare, or hospital administration, or other field closely related to patient business services.
• Experience: Three years of supervisory experience, which included responsibility for revenue cycle activities in a hospital or healthcare organization.

Work Schedule

This position is strictly on-site, with no remote work options. The first 30 days of training will follow a 5/8 schedule.