Under the direction of the Manager of CDM and Charge Capture, the Revenue Integrity Specialist is responsible for documenting and supporting the charge capture practices for Renown Health System. The Specialist will support the data gathering for the review and maintenance of the hospital and professional chargemasters, charge documents, and charge capture processes. The Specialist will ensure that claim edits for Revenue Integrity are worked to resolution to ensure that claims are not held up from billing to maximize organizational reimbursement.
Nature and Scope:
Under the direction of the Manager of CDM and Charge Capture the Specialist will be responsible to:
a. Track and trend data on late charges, provides weekly and monthly reporting to Renown Health leaders.
b. Keep an issues log of findings/issues/action plans for the work ques under Specialists responsibility
c. Identifies, researches, and analyzes charging errors and/or omissions, working collaboratively with appropriate department staff/team members to ensure that revisions/corrections are made
d. May address routine system issues, referring non-routine matters to department leader.
e. Prepares reports, and provides departmental summary information to the health network which is responsible for ensuring that all charges on a system wide basis are being captured and charged appropriately
f. Assists interdepartmental teams in troubleshooting accounts that are being held for billing in edits due to charging/documentation discrepancies
This position does not provide patient care.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications: Requirements - Required and/or Preferred
Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelor's Degree preferred.
Medical terminology experience preferred. Two years in hospital revenue cycle with knowledge of charging practices preferred.
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Computer literacy, including word processing, spreadsheet applications, database management and Microsoft office (Access).