Inspire health. Serve with compassion. Be the difference. Job Summary Coordinates timely, comprehensive charge reconciliation for Perioperative Services. Performs internal charge audits and assists supervisor in overseeing the Chargemaster for assigned enterprise-wide departments. Coaches staff regarding coding and billing issues. Reviews escalated accounts and issues providing coding expertise. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Performs audits intraoperative logs for Perioperative Services to include surgery, recovery, and anesthesia. Reviews nursing/anesthesia documentation and operative notes to assure timely, complete, and accurate billing of supplies, implants, and facility fees for assigned areas of responsibility. Assigns appropriate CPT codes based on surgeon documentation according to CMS CPT Guidance. For device dependent procedures, assures all device charges have been captured. Performs internal charge review audits and documents audit findings as directed. Supports Periop Revenue Integrity Charge Specialists in identifying and resolving complex cases, answering questions, and providing education to same. Assists the Periop Coding Analyst to resolve specific charge capture issues with the Perioperative charge team and other departments to include Revenue Integrity, Patient Accounts and HIM. Follows established departmental guidelines and consistently, appropriately, and proactively notifies nurses, anesthesia staff and physicians of both documentation and charge capture deficits and issues needing clarification. Documents follow-up to assure timely resolution and in support of both documentation and revenue cycle integrity. Provides research and analysis of accounts in assigned Epic work queues and from other departments. Uses knowledge of billing and coding conventions and CMS rules and regulations to analyze and resolve account issues. Aids with editing and correcting of failed claims related to coding by reviewing charts to verify supplies/implants/devices used and appropriate codes assigned. Oversees the maintenance of CDMs in departments of responsibility. Assists in determining if items are chargeable and identifies appropriate coding to include revenue and HCPCS codes. Identifies and corrects supplies and implants that need item numbers and charge codes. Performs other duties as assigned.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED