Revenue Integrity Audit
Community Health Systems
**Job Summary**
Under limited supervision, supports various strategic and operational objectives of the organization's revenue cycle and unbilled processes. Collaborates with other departments and staff to investigate and improve revenue cycle performance.
**Essential Functions**
+ Works the DNFB report to insure unbilled accounts are in 3 M 360 task queue for coder to process (prioritizing high dollar and oldest accounts.
+ Works with Ancillary departments, HIM designated employees and coding Manager to insure the high dollar and oldest accounts on the Coding Holds report are processed daily.
+ Communicates with departments daily to resolve charge problems so that accounts can be returned to Coding for processing.
+ Utilizing the DNFB and Coding Holds report develops and distributes a report by Patient Type//Patient Service to Ancillary/Clinic Directors who are responsible for resolving unbilled reason for account and coding hold.
+ Completes the Corporate Coding Hold Weekly Report to include reason why accounts on hold, number of accounts on hold, monies holding for said accounts and top three physicians with outstanding documentation to include number of accounts and monies.
+ Participates in Weekly Unbilled Coding Call with Coding Manager et al to provide status update on improvements, barriers, and any action items which may require a ticket to be opened.
+ Participates in weekly Revenue Cycle meeting to gather information to share with or seek advisement of from the regional Coding Manager,
+ Works with the HIIM Director to complete an Unbilled Action Plan and participate in the call in the event the facility(s) is below the Corporate standard of 3.0 days
+ Manages Unbilled Team (ER abstractors and MPI Coordinator/Transcription support) in HIIM Department to allow for accounts on unbilled belonging to HIIM Department are worked daily and returned to Coding Services
+ Reviews all SSI Holds assigned by the Shared services center and resolves missing documentation or charge errors.
+ Assembles and organizes all reference material including any and all communication regarding chart document requirements
+ Coordinates with coding, business office and hospital departments on documentation needed to complete accounts for billing/coding.
+ Utilizes effective communication skills to maintain open and ongoing exchange of information among team members
+ Changes work activities as documented in utility system downtime policy.
+ Serves as back up to HIM and HIM Supervisor as needed
+ Trends Unbilled Alert days and provides unbilled trending report to the HIM director daily.
+ Communicates with physicians and office staff as needed to obtain missing documentation needed for coding.
+ Performs other duties as assigned.
+ Complies with all policies and standards.
**Qualifications**
+ H.S. Diploma or GED as recognized by the U.S. Department of Education required and
+ Bachelor's Degree Accounting, Finance, Business, or related. required
+ 2-4 years recent health information management experience required
**Knowledge, Skills and Abilities**
+ Knowledge of medical records preferred.
+ Organizational skills, attention to details, and ability to meet deadlines.
+ Ability to complete assignments independently with little supervision.
+ Good verbal and written communication skills required to effectively assist department customers.
+ Demonstrate proficiency with computers and various software and applications such as Microsoft Word and Excel.
**Licenses and Certifications**
+ CPC and/or CCSP - Certified Professional Coder required or
+ CCS - Certified Coding Specialist required
Equal Employment Opportunity
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
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