Revenue Guardian Senior | Revenue Integrity | Day | Full-Time

University of Florida Health • Gainesville, FL

70d

About The Position

The Senior Revenue Guardian is responsible for providing support for timely, accurate and inclusive charge capture; coding assignments; billing functions and revenue routing to medium to high-complexity hospital departments through performance of record audits, evaluation of regulations and payer guidelines, monitoring work queues, execution of staff education and other related activities. This position facilitates the resolution of undercharges, overcharges and coding errors to assure appropriate and compliant revenue in addition to performing charging analysis to identify trends of missing or misdirected charges to resolve charge capture related issues. Additionally, this role is responsible for the timely respond to ADR, CERT, PERM, RAC and other third-party payer audit requests. Monitors the revenue and usage, late charge, and interface exception reports to ensure all revenue is captured and posted in the billing system.

Requirements

• Bachelor’s degree in a health or business-related field OR Associate’s degree from an accredited College or University OR 2 years of related experience.
• CCS, CCS-P, CPC, CPC-H, CCA and 3 years coding, auditing or related work experience.
• Experience with Health Information Management (HIM), Facility/Physician Billing, Charge Description Master (CDM), Denials Management, Charge Integrity, Financial Analysis or Certification in Auditing and/or Healthcare Compliance preferred.
• Knowledge or experience related to coding and/or medical record review procedures.
• Experience auditing medical records for billing/insurance purposes.
• Ability to work independently and solve problems, as well as collaborate and share knowledge with team members.
• Demonstrated knowledge of third party billing and collection processes, cash application processes, managed care, Medicare, Medicaid and other government programs.
• Experience with Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel and Access.
• Possess effective oral and written skills.
• Working knowledge of multiple healthcare applications, including but not limited to SDK, EPIC, 3M and CDM maintenance software.
• Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel.
• Strong interpersonal, facilitation, coordination and customer service skills.
• Ability to apply analysis, definition and documentation for business, systems and data processes.
• Analytical skills and competence in problem definition and strategy development for resolution.
• Ability to manage multiple projects and follow up on all projects.
• EPIC workflow and reporting experience preferred.

Responsibilities

• Provide support for timely, accurate and inclusive charge capture.
• Perform coding assignments and billing functions.
• Route revenue to medium to high-complexity hospital departments.
• Conduct record audits and evaluate regulations and payer guidelines.
• Monitor work queues and execute staff education.
• Facilitate the resolution of undercharges, overcharges and coding errors.
• Perform charging analysis to identify trends of missing or misdirected charges.
• Respond timely to ADR, CERT, PERM, RAC and other third-party payer audit requests.
• Monitor revenue and usage, late charge, and interface exception reports.

What This Job Offers

• Career Level: Senior
• Industry: Hospitals
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees