Tidelands Health Charge Capture Supervisor - Revenue Integrity (Pawleys Island, SC) in Myrtle Beach Area, South Carolina
Position Summary: Primarily responsible for managing charge capture staff and daily operations of these functions within the Him department. Responsible for all charge capture training reports as well as other data and reporting. Oversees and help to establish positive vendor, physician, and customer communications. Responsible for management of completed reports management and completes other duties as assigned while exhibiting exemplary core customer service skills. Completes accurate and timely charge capture by enter charges where necessary and reviewing clinical documentation to validate all charges are captured.
Reviews and reconciles the Revenue and Usage report daily.
Works assigned charging work queues daily.
Educates caregivers on charge capture as omissions or errors are identified.
Identifies inconsistencies and works with Clinical Informatics to streamline charge capture process.
Follows compliant charge capture in accordance with Medicare, Medicaid or Third Party payer guidelines.
Communicates with various members of the billing team with the understanding that billing begins with the capture process.
Assists with and works in cooperation with CDM managers to establish charge capture and CDM maintenance practices and methodologies. Recommends revisions to charge codes and submits requests for charge codes for new services.
Provides input into financial analysis and other documentation, as required. Identifies departments with potential for revenue cycle improvement and works with department managers to correct problems.
Monitors results of improvement in revenue cycle. Communicates with Physicians/Providers, Health Information Management, Ancillary, Nursing, Patient Accounting, Information Services, Compliance, and Managed Care departments regarding charge capture and CDM-related activities. Provides feedback to clinical staff on completeness and accuracy of documentation. Reviews National Coverage Determinations and Local Coverage Determinations with applicable departments.
Evaluates the current charging structure and streamlines the charge process by the elimination of duplicate, inactive or non-compliant charges.
Assesses the accuracy of charge forms, charge screens, charge stickers and other charging vehicles. Trouble shoots charge capture and documentation issues.
Participates in denial management by assisting with the appeal of 3rd party payer denials. Analyzes data obtained for evidence of deficiencies in controls, duplication of effort, fraud, or lack of compliance with laws, or government regulations. Utilizes this data to assist in the development of CDM and charge capture policies or procedures.
Researches changes in governmental and 3rd party payer rules and regulations as related to charge entry and makes appropriate changes in systems and processes to achieve and maintain compliance.
Works and/or monitors error reports and provides input to coding staff or department on error reconciliation daily.
Assists with development of policies, procedures and job aids related to coding and charge entry. Translates regulatory requirements into daily operating procedures. Assists with the preparation of special reports for Leadership to document utilization of the charge capture outcomes (e.g., late entry volumes, pricing impacts, etc.).
Serves as relief support based on work schedule or workload demands. Serves as a resource to train new associates.
Maintains cross training in various functions to assist in the smooth delivery of departmental services.
Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue integrity and healthcare in general. Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle operations.
Performs other duties as assigned by leadership, including but not limited to leading and conducting special projects.
Two to three years’ experience in a health care organization.
Knowledge of outpatient charging and OPPS rules.
Must have knowledge of medical terminology.
Ability to work with department to identify charge revenue opportunities and ways to improve charge capture
Previous Experience as healthcare coder-apprentice or assistant preferred or years of experience
Prior experience coding as apprentice or assistant as part of a hospital system preferred
Exemplary oral and written communication skills required.
Strong interpersonal relationships skills to establish positive rapport with vendors, physicians, co-workers and ancillary personnel required.
Advanced knowledge of PC software (Word, Excel, PowerPoint, etc.) required.
- Certification as a CCS or CPC highly preferred.
Candidates preferred to have:
Current credentialed as CPC (Certified Professional Coder)
Current credentialed as CCS (Certified Coding Specialist)
Eligible to take certification exam for CCS or CPC
Physical Requirements: Light Physical Agility Testing (PAT) Rating
While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert up to 15 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or up to 5 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job and will be measured by post offer Physical Agility testing with a required “Light” rating to verify ability to meet the requirement.
Job ID: 2020-8174
Shift: Weekday - Days
External Company Name: Tidelands Health
External Company URL: http://www.tidelandshealth.org/
Street: 4070 Hwy 17 Bypass