Start the day excited to make a difference...end the day knowing you did. Come join our team.

Essential Functions & Responsibilities:

• Identifies root causes of edits; collaborates with Patient Financial Services, Corporate Compliance and Clinical Departments to reduce the occurrence of edits.
• Resolves coding-related claim edits (e.g. CCI, LCD) on outpatient hospital claims.
• Collaborates with CDM Analyst to resolve charge errors and ensures hospital services are correctly charged and billed appropriately to the patient.
• Assists in the analysis and resolution of outpatient ancillary denials. Reviews denials to identify trends.
• Works with departments, operational and business managers to develop and reinforce process improvement activities in the areas of charge capture integration, charge reconciliation, and revenue cycle training.
• Reviews all observation patient documentation to determine appropriate hours to be billed based on carve outs, in addition to documentation for infusion and injections.
• Works with Patient Accounting (Denials Billing and Third Party) to identify issues related to denied charges for hospital services.
• Meets with clinical departments quarterly to communicate variances and opportunities to improve overall charge capture.
• Assists with updating and providing education support regarding identifying existing charging problems and developing resolutions.
• Audits charge capture utilizing software tools. Provides feedback to the various departments based on audit results.
• Performs other duties as assigned.

Qualifications:

• High school or equivalent required.
• CCS, CPC-A, CPC, COC-A, COC, CIC-A, CIC, RHIT or RHIA certification required.
• A minimum two years Patient Accounts Billing, Compliance, or Revenue Integrity related work experience is preferred.
• Knowledge of general hospital billing processes, medical terminology and coding guidelines is required.
• Excellent organizational, oral and written communication skills.
• Familiarity with hospital charging systems and knowledge of CPT, HCPCs, Revenue Codes and Revenue Cycle preferred.
• Prior experience with Microsoft Excel and Word, Cerner, 3M, MedAssests and/or ICD-10 is preferred.
• Ability to facilitate education and apply critical and analytical thinking skills is preferred.

As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.