Overview
This full-time remote position involves reviewing and auditing all inpatient and outpatient pre-transplant charges to ensure accuracy, compliance, and proper classification. The role requires verifying that both transplant and non-transplant related charges are processed and recorded appropriately in accordance with corporate policies and governmental regulations. The position supports the accuracy of the annual Medicare Cost Report by ensuring charge integrity and compliance with reporting requirements. It includes identifying discrepancies, performing detailed analysis, and collaborating with clinical, billing, and finance teams to resolve issues and improve processes. This role is essential for maintaining financial accuracy, regulatory compliance, and operational efficiency within transplant-related revenue cycle activities.
Work Style: Remote
Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX)
FTE: Full-Time (1.0 FTE)
Responsibilities
- Review charge work queues for transplant and donor patient hospital and professional charges across all organ programs
- Identify, track, and resolve missing or misrouted charges in collaboration with Coding, Patient Financial Services (PFS), and clinical departments
- Assist with preparation of audit documentation for Medicare Cost Reports and other regulatory submissions, as needed
- Participate in cross-functional meetings and support Charge Capture Review Team initiatives
- Collaborate with IT analysts and Epic teams to optimize charge capture tools and workflows within Epic
- Partner with Transplant Financial Coordinators and Transplant Nurse Coordinators to verify transplant phase, as needed
Requirements
- Minimum of two (2) years of experience in healthcare revenue cycle, charge capture, coding, or transplant operations
- Active nursing license or coding certification (e.g., CCS, RHIT, RHIA, CPC, COC, CIC, or CCS-P)
- Proficiency in revenue integrity, billing, and audit tools; experience with EHR systems (Epic preferred)
- Working knowledge of transplant billing and compliance requirements
- Demonstrated ability in process improvement and problem-solving within complex healthcare environments
- Experience with clinical chart review and data abstraction