Revenue Integrity Charge Capture Analyst

Description

Salary Range : $92,768 - $125,236

Job Description

Division : Finance

Job Title : Revenue Integrity Charge CaptureAnalyst

Job Code : 13U

Position Summary

Responsible for ensuring accurate and complaint charge capture and maintaining the integrity of the CDM. The analyst plays a key role in analyzing billing and coding processes, identifying discrepancies and areas for improvement, and implementing solutions to enhance revenue integrity and financial performance.

In addition to performing the essential functions listed below, may also be assigned other duties as required.

Statement of Accountability

Reports to : Revenue Integrity Manager

Qualifications

• Education
• Licensure
• Work Experience
• Skills / computer / specific technical
• Other qualifications, miscellaneous

Specify if qualifications are Required or Preferred

Required : HighSchoolGraduate.BachelorDegreeand / orRNDegreepreferred.

Required : 1-3yearsChargemasterexperience.

Desired : NursingorClinicalBackground, CCS (Certified Coding Specialist) or CPC (Certified Professional Coder) credetnails helpful

Required : StronganalyticalskillsandSelf-starter.

Required : TechnicalproficiencywithMicrosoftExcel.ExperiencewithMicrosoftWordforreportingpurposes.

Required : AbilitytoworkeffectivelywithPatientFinancialServices,FP&Aandhospitalrevenuegeneratingdepartmentsutilizingexcellentcommunicationskills.

Required : Abilitytoprioritizeandworkefficientlywithminimalsupervisionandworkindependently.

Required : Familiaritywithgovernmentprogramreimbursementstructures.knowledge of hospital billing, coding, and reimbursement processes, including familiarity with ICD-10, CPT and HCPCS coding systems.

Essential Job Responsibilities

Achieving Results

Key Components : assess, plan, evaluate, demonstrate initiative, quality of work, productivity

1. CDM Management Assists Revenue Integrity Manager in maintaining and updating the Charge Description Master (CDM) to ensure it is accurate, complaint, and reflective of current clinical services and procedues.

2. Charge Capture Analysis - Works with all Revenue generating departments to insure that charge protocols and charge capture and reconciliation processes are adhered to.

3.WQ Management - Performs daily review of charge review work queues as it relates to high quantity and high dollars to insure departments are charging approrpriately andrevenue posted is correct.

4. Issue Resolution Assists in resolving billing discrepancies and denials related to charge capture and CDM inaccuracies.

Demonstrates Skill

Key Components : competency, job knowledge, organizational skills, analytical skill, management of information, employee & patient safety

1. Monitors governmental program updates with regards to coding changes as it relates to billing.

2. Demonstrates competencies on all computer systems and applications utilized to complete job duties; understands integration of information between financial systems.

3. Tracks and monitors significant charging issues to include late

charges and reports them back to Senior Finance Management.

Planning & Coordinating

Key Components : delegates, decision making, problem solving, management of resources

1. Participates as member in the Compliance Task Force and Internal Audit Committee and reports all compliance issues to Director of PFS, CFO and Chief Compliance Officer.

2 Works closely on all new IT projects where charge interfaces are affected to insure proper testing is completed prior to any Go Live.

Professionalism

Key Components : dependability, interpersonal skills, teamwork, patient first ethic, customer service, communication skills, punctuality / attendance, receptiveness to criticism, judgment, confidentiality

1 . Maintains excellent customer service skills with hospital departments, office staff, employees, insurance plans, and vendors.

2. Demonstrates good judgement when communicating with patients / customers of various age groups by modifying delivery and complexity of information based on age.

3 Maintains Patient First Ethic at all times.

4. Demonstrates strong adherence to punctuality and attendance based on hospital policy.

5. Displays positive work attitude.

Improving the Organization

Key Components : performance improvement, quality initiatives

1. Participates in all performance improvement activities to include hospital CQI activities

2. Performs special projects and other duties as assigned.

Self-Development

Key Components : maintain license / certification, education and training

Seeks to improve performance by participation in self- development activities such as outside classes or seminars available.

Regulatory Compliance

Key Components : JCAHO, Title 22, OIG, HIPAA, State / Federal laws, hospital policies

Maintains confidentiality of all hospital information. Safeguards protected health information from any intentional or unintentional disclosure according to HIPAA regulations.

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