Description
Summary: Provides oversight and guidance to the Revenue Integrity Department and serves as the Revenue Integrity Analysts direct report. This position will assist the department where need be, and respond to any issues related to coding, billing, and revenue when trends arise, needing immediate resolution. They will learn month end processes and reporting, in case the Director is unavailable, and understand all charge processes, including CDM creation. Other duties may be assigned. Responsibilities: - Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria appropriate population in his/her assigned area
- Maintains required core competencies.
- Complies with set Policies and Procedures (i.e. nametag, dress code, parking, smoking, etc.)
- Assure prompt patient services with professional kind attitude.
- Assist the Patient Financial Services department with claims resolution ? NCCI Edits, MUE, late charges, missed charges, etc. Provides resolution within 24-48 hours.
- Review Revenue and Usage reports to identify trends leading to missed revenue, puts processes in place, and monitors that resolution is implied and working.
- Understands month end processes for Revenue Integrity, to assist with Accounting?s Month End Closes.
- Understand charges processes driven in the Cerner Community Works system, and helps resolve issues reported by Revenue generating departments that are preventing charges from being realized.
- Can create CDM?s, and ensure proper mapping of revenue to the hospital general ledger.
- Provides guidance to the Revenue Integrity Analysts with complex issues, and if cannot resolve, report to Director.
Requirements: Education: - High School diploma or equivalent.
Experience: - Clerical training that includes typing, 10 key calculator, and computer knowledge. Knowledge/Experience of computer software, insurance requirements (authorizations, policies, co-pays, etc.).
- Experience with Cerner Community Works EMR/ Billing Platform is preferred.
- Minimum of 4 years? experience in a Healthcare Revenue Cycle
- Proficient knowledge in Healthcare Billing & Revenue Cycle (Certifications ? CRCR, CPB, and CBCS a plus)
- Knowledge in report writing within the Discern Analytics 2 (DA2) program
Licenses, Certifications, or Registrations: - Current American Heart ?HeartSaver or Basic Life Support (BLS)card.
- Certification in Coding ? CPC, COC, CIC, CCS
Work Type: Full Time
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