Periop Revenue Charge Specialist, Patewood, FT, Day

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Job Summary

Essential Functions

• Daily audits charges and enters facility fees for Perioperative Services into the Perioperative Information system to include surgery, preop, and recovery. Analyzes relevant nursing documentation and encounter forms to identify descrepancies in order to accurately capture all revenue. Enters or credits all implant and supply charges as required into the OPTIFLEX and Demand bill systems assuring accurate and completes charge capture. - 35%

• Performs daily audits of revenue cycle charge proof reports and Bipas against surgeon's operative note and all other nursing documentation to assure timely, complete and accurate billing for compliance and maximum reimbursement within AR timelines. Reviews procedures for appropriate CPT codes based on all documentation to assure correct facility fee. The auditing process includes accessing multiple downstream systems for compliant charge capture and documentation integrity. - 30%

• Follows established department guidelines and consistently, appropriately and proactively notifies nurses of errors in both documentation and charge capture for correction and clarification to assure both documentation and revenue cycle integrity. - 10%

• Daily records clinical charge errors discovered through detailed audits processes into department access data base to provide RN Perioperative Business Services documentation necessary in the development of in-services and one on one coaching for the clinical staff. - 10%

• Monitors, researches and responds to periodic billing problems for Perioperative Services including identifying supply/implants needing item and charge numbers and for CCA and Xclaim inquiries. Follows up and resolves problems in a timely manner communicating effectively with coworkers, nurses and management stadd. RN Perioperative Business Services. For late charges, follows established protocols. - 10%

• Assists RN Perioperative Business Services and Manager in annual review of department policies and procedures. Assumes additional projects as assigned by management. - 5%

• Performs other duties as assigned.

Supervisory/Management Responsibilities

• This is a non-management job that will report to a supervisor, director or executive.

Minimum Requirements

• Education - High School diploma or equivalent OR post-high school diploma/highest degree earned

• Experience - 3 years - Health Care Revenue Cycle

In Lieu Of

• In lieu of the experience and/or educational requirements indicated above a combination of education, training, and/or experience will be considered an equivalent substitution: Coding certification from an accredited organization: AAPC, AHIMA or ACMCS or (5) years in a health care facility or physician office practice to include working knowledge of ICD9-CM, CPT/HCPCS,UB-04 revenue codes and /or denials or (5) five years in Health Information Management with working knowledge of ICD9-CM,CPT/HCPCS.

• Team members employed in this job prior to July 1, 2020 are grandfathered under prior educational and experience requirements. In addition, team members must be certification eligible and will have one year to obtain required certification(s).

Knowledge, Skills and Abilities

• Knowledge of office equipment (fax/copier)

• Proficient computer skills (word processing, spreadsheets, databases)

• Data Entry

• Mathematical Skills

• Typing skills

• Working knowledge of medical terminology, anatomy, physiology. Which can be obtained by on-the job training or through college courses. - Preferred

• Familiarity with ICD9-CM, CPT/HCPCS and UB04 codes - Preferred

• CPC to be obtained 2 years after date of hire - Preferred

Work Shift

Location

Facility

Department

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