Revenue Cycle Improvement Coordinator

Rochester Regional Health

10d

About The Position

Under the guidance of the VP, Revenue Cycle Management, the coordinator independently audits and evaluates the Health System revenue cycle related workflows, identifies problem areas, provides solutions, and assists in the implementation of workflow improvements to assure an effective revenue cycle process. Maintains hospital charge master including participation in the Hospital Pricing Committee, provides recommendations for changes and coordinates the implementation of new/revised charges.

Requirements

Bachelor’s Degree in Business, Accounting, Health Information, other health care related field required.
Proficient in utilizing Excel for data analysis, reporting, and visualization.
Strong ability to interpret data, identify trends, and make data-driven decisions.
Excellent verbal and written communication skills for interacting with internal teams and stakeholders.
Familiarity with Epic EHR management and workflows.
Background in the healthcare industry, with an understanding of medical terminology, CPT/ICD codes, insurance claims, and billing procedures.
Healthcare experience preferred.

Responsibilities

Maintain an accurate and complete hospital chargemaster (CDM) ensuring competitive pricing, appropriate reimbursement and compliance with governmental billing regulations
Manage the department chargemasters by scheduling, coordinating, and monitoring departmental CDM reviews and updates. Documents all CDM recommendations.
Complete the CDM review by obtaining appropriate department head approval, coordinating the effective date and completion of the finalized system changes, and rebilling and/or crediting of services. Report all potential compliance related issues.
Develop and update CDM Review and charge services policies and procedures including overall health system, standard, and department specific as needed.
Perform ongoing audits and education to hospital clinical departments on procedures to maintain compliance and integrity of the chargemaster
Coordinate and monitor all new charge requests (procedures, supplies and pharmacy) including all pre work research, pricing and final approvals.
Identify, coordinate, and monitor quarterly and annual HCPCS and APC changes.
Monitor the weekly Department charge Entry Lag Report. Work with department leaders to achieve the health system goal of charge entry with 1-2 days where possible, including performing operational reviews when necessary.
Identify and report revenue cycle opportunities to the Revenue Cycle Director meeting monthly / annual goals.
Perform ongoing audits, analyze audit results and create recommendations for optimizing the revenue cycle functions.
Manages follow up activities to keep revenue cycle initiatives moving forward in a timely manner
Support financial and administrative oversight of managed care contracts with commercial payers
Support contracting activities including preparation for negotiation, implementation and analysis of reimbursement performance
Leads or participates in project teams designed to improve revenue cycle, as needed.