Coord- Charge Integrity

United Regional•Wichita Falls, TX

About The Position

Summary of Essential Functions: Responsible for the complete accuracy of the Charge Master, claim scrubber, claim forms and other assigned AR system applications. Works with coding and Billing Department to coordinate correct HCPCS code assignments. Works with ancillary departments on identifying and utilizing procedures and charges. Provides new department charge listing and reviews new yearly codes with each department. Works with Epic IT Team and departments on Epic training and assists with Billing Department as needed. Works with Epic IT team to ensure CDM accuracy & updates as needed. Responsible for requesting, testing, and validating appropriate charge usage. Audits departments for correct charging as assigned. Prepares comprehensive analysis to include validated data gathering from the computer systems financial applications for management reporting. Educational Requirements: High school diploma required; College Degree desirable. Four years’ experience is required in a Billing/Finance/IS setting with emphasis in Billing Procedure Analysis. Experience in healthcare of at least 2 years may be required. Must be able to communicate effectively in English, both verbally and in writing. Knowledge/Skills/Abilities: Four years of experience in the acute care hospital or community-based healthcare/continuum of care environment strongly preferred. Experience with computers required. Also must have clerical and/or computer data entry experience. Knowledge of HCFA and other regulatory billing requirements as related to charging. Must be knowledgeable in CPT, HCPCS coding, UB, 1500 and third party billing requirements. Ability to use PC based applications such as Microsoft Word and Excel

Requirements

High school diploma required; College Degree desirable.
Four years’ experience is required in a Billing/Finance/IS setting with emphasis in Billing Procedure Analysis.
Experience in healthcare of at least 2 years may be required.
Must be able to communicate effectively in English, both verbally and in writing.
Experience with computers required.
Also must have clerical and/or computer data entry experience.
Knowledge of HCFA and other regulatory billing requirements as related to charging.
Must be knowledgeable in CPT, HCPCS coding, UB, 1500 and third party billing requirements.
Ability to use PC based applications such as Microsoft Word and Excel

Nice To Haves

Four years of experience in the acute care hospital or community-based healthcare/continuum of care environment strongly preferred.

Responsibilities

Ensures Billing Code File is accurately set to meet payer and governmental regulations for paper and electronic claims.
Identifies and corrects reported errors or issues.
Ensures maintenance complete and up to date hospital master file of charges and CPT/HCPCS and Revenue Codes.
Responsible for accurately and timely adding and updating prices, CPT/HCPCS codes, revenue codes, new charges, coding and billing requirements to achieve maximum reimbursement while ensuring governmental regulations and compliance rules are met.
Provides in-house support to all users of hospital financial applications such as Billing in Epic, AR, Charge Master, and Electronic Billing.
Ensures GL Distribution Application is updated and correct information entered to route revenue to appropriate departments as assigned by Accounting Director.
Coordinates maintenance of room files to ensure accuracy of nursing station assignment and accommodation codes for correct charging.
Runs assigned queries utilizing computer system to list requested information in correct sort order.
Ensures accuracy prior to submitting to requestor.
Responsible for working with Clinical Staff, Pharmacy, and Materials Management to ensure corresponding charge numbers match and are appropriate for accurate charging and billing.
Ensures communication with current computer system vendor.
Reports and documents system problems with current vendor to ensure correction or enhancement for processing accuracy and efficiency for assigned applications.
Effectively communicates with hospital departments to ensure maximum usage of the computer system as well as compliance and processing efficiency.
Educates, trains, and provides the necessary documentation to ensure departments fall within billing compliance guidelines as well as meeting hospital policy and guidelines in relation to charges.