ED Revenue Integrity Specialist II, Remote

UofL Health

5d•Remote

About The Position

This position is responsible for performing daily revenue integrity audits and charge reconciliation to support the accurate and timely capture of Emergency Department (ED) charges. Daily monitoring of patient board and review of census and discharges to ensure that required documentation is present to facilitate charge capture. Daily review and processing of ED facility level charges, ED procedures, injections, infusion, other administrations, and pre-bill edits. Interacts as needed with internal customers to include but not limited to hospital staff, ED care providers and leadership, and other revenue cycle team members. Actively participates in department and hospital performance initiatives when needed to ensure overall UofL Health success.

Requirements

Knowledge of medical terminology, anatomy and physiology.
Ability to foresee projects from start to finish as well as identify trends in charge reconciliation data.
Demonstrate working knowledge of Electronic Medical Record (EMR) and Billing systems. Cerner (EMR) and McKesson STAR (Billing) preferred.
Must be able to communicate effectively in both verbal and written formats.
Strong critical thinking skills.
Demonstrate strong Microsoft Office knowledge skills.
Minimum high school education or GED required.
ED Revenue Integrity Specialist II requires the upkeep of one of the following nationally accepted Certified Coding Credentials (I.e., RHIT, RHIA, CPC, CPC-H, CCA, CCS, or CCS-P).
Minimum 1 year of experience in acute healthcare setting working with charge entry, charge description master (CDM), and/or healthcare billing is required.
Ability to maintain confidentiality of sensitive information required.
ED Revenue Integrity Specialist II requires 3 years of prior outpatient coding (preferably ED coding), ED technician, or ED clinical nursing experience in addition to the certified coding credential.

Nice To Haves

Experience related to charging for Infusion and Injection medications and ED Leveling is preferred.
Prior experience ED facility coding, a plus.

Responsibilities

Timely review and capture of emergency department (ED) facility level charges using points tool.
Maintain productivity standards by ensuring that ED charge capture remains current or entered within 3 days of patient discharge.
Maintain overall financial viability for UMC Revenue Cycle through collaboration and effective communication with ED care providers and leaders as well as coding, billing, and other charge entry staff.
Collaborate with care providers to resolve missing documentation needed to accurately capture ED charges.
Assign the appropriate ED facility E/M level, procedure, injection/infusion and administration charges for hospital services in accordance with CMS Official Coding Guidelines for Coding and Reporting.
Assign appropriate modifiers with ICD-10-CM, CPT and HCPCS Level II codes.
Research and resolve billing and coding issues for ED pre-bill edits to ensure timely filing of clean claims and overall reduction of discharge, not final bill (DNFB) status.
Maintain productivity standards by working to resolve outstanding ED-related pre-bill edits timely.
Assists with education of clinical service line regarding coding and billing.
Attend required continuing education workshops, webinars, etc., for coding/billing compliance.
Gather and report trends and/or findings regarding billing errors to appropriate revenue cycle leadership.
Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
Adheres to and exhibits our core values: Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness. Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
Maintains confidentiality and protects sensitive data at all times.
Adheres to organizational and department specific safety standards and guidelines.
Works collaboratively and supports efforts of team members.
Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.