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Technical and Critical Thinking Functions * Reconciles schedule of daily accounts to ensure that all charges are captured in the Accounts Receivable system * Reviews charges posted to ensure accuracy for type of case, type of procedure, coding/billing rules and edits charges as appropriate. * Maintains and updates charge screens in the Electronic Medical Record system. Also maintains any other charging methodology by department. * Follow up on late charges and write-offs by reviewing reports weekly to determine that revenue is appropriate. * Researches any deviation to expected revenue and proposes solution. * Maintains department charge master files. Reviews charge master every six months and submits changes as appropriate. * Works with department manager and Revenue Integrity Manager to ensure proper pricing, description codes and coding for new procedures or changed procedures. * Audits medical records against charges and claims for improvements in charge capture and documentation. * Accurate understanding and interpretation of medical records, hospital bills and charge master to ensure high-performing revenue capture. |
Communication Function * Responds to queries regarding department charges, providing responses and explanations and any information needed. * Identifies areas of improvement, prepares summary of findings to department manager and Revenue Integrity Manager and educates department staff as appropriate per managers' approval. * Represents department(s) with any compliance audit as needed. * Develops and maintains effective relationships among internal/external stakeholders, colleagues and staff in order to build trust and facilitate individuals/teams through change initiatives. |
Quality and Education Function * Reviews department medical record documentation on a quarterly basis for improvement opportunities. * Ensures knowledge and understanding of governmental and accreditation body standards for documentation of department's services and coverage. * Makes monthly observations and recommendations to prevent future revenue losses. |
Compliance/Safety * Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner. * Maintains confidentiality of all department, patient, and billing matters. * Completes all company mandatory modules and required job specific training in the specified time frame. * Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility. * Meets industry standard measures of productivity and accuracy. |
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