Overview
This role involves performing Charge Capture Reconciliation Audits across multiple hospitals within a health system to ensure compliance with departmental charge capture and reconciliation policies. The position requires reporting audit findings, assisting leadership with corrective action plans, maintaining expertise on third-party billing regulations, and analyzing reimbursement and charge data.
Responsibilities
- Conduct Charge Capture Reconciliation Audits for all hospitals within the health system.
- Report findings monthly via a Revenue Integrity Audit Scorecard for each audited facility.
- Assist Revenue Integrity Leadership in facilitating monthly meetings to discuss audit findings.
- Support Departmental Leadership in developing corrective action plans and training for non-compliant areas.
- Re-audit to verify improvements in charge reconciliation compliance rates.
- Maintain up-to-date knowledge of Third Party Billing Regulations and ensure compliance of Epic EAP/CDM systems.
- Develop educational tools and communications for revenue-producing departments.
- Analyze reimbursement and charge data for service line analysis and special projects.
- Develop and maintain understanding of systems involved in charge updates and related PC skills.
- Lead and facilitate a robust audit program monitoring charge reconciliation reports and review work queues.
- Maintain facility-specific scorecards including corrective action plans and recognition for compliance.
- Escalate non-compliance issues to designated leadership and collaborate on corrective actions.
- Conduct monthly Revenue Integrity Audit Scorecard presentations to facility leadership.
- Share audit results and corrective action plans with finance and clinical leadership.
- Provide professional, customer service-oriented responses to questions regarding charge appropriateness.
- Stay current on EPIC or related EAP software functionality and hospital billing system processes.
- Utilize Excel and other software to manipulate, summarize, and analyze data.
Minimum Requirements
- Bachelor's Degree preferred.
- 3 to 4 years of relevant experience required.
- RHIA or RHIT certification preferred.
- Experience in physician billing, charging, and/or coding preferred.
- Demonstrated ability to manage, teach, make independent decisions, and assume responsibility.
- Strong interpersonal communication skills, both verbal and written.
- Ability to communicate and work effectively with all levels of staff.
- Proficiency with PC-based applications such as Word, Excel, PowerPoint, and Outlook.
- Leadership and teamwork skills with the ability to execute desired outcomes.
- Creative and positive problem-solving abilities.
- Ability to foster collaboration among multiple parties.
- Strong planning, organizational, and presentation skills.
- Conceptual thinking with practical application.
- Ability to assimilate and analyze information from various sources to determine appropriate actions.
- Openness to diverse opinions and incorporation into decision-making.
- Commitment to high standards of customer service.
Compensation & Benefits
- Competitive benefits package.
Location
- Remote role based out of Greenville, NC.
- Monday through Friday, day shift schedule.