Audit and analyze the charge capture and revenue monitoring functions of a complex teaching, research and clinical care facility dedicated to the care of infants, children and adolescents.
·Charge Capture Reviews
Support the performance of regular charge capture reviews. Audit billed charges to patient's medical records and supporting documentation. This will require detailed analysis of the billed charges, medical records and any related medical documentation, such as the physician's dictation, referral letters, and diagnostic documentation. Analyze department's processes and workflow to assist department in enhancing maximum charge capture and reduce the occurrence of late charges. Collaborate with Billing Compliance Department to ensure that charges are compliant with Federal Regulations. Perform detailed data analysis to quantify revenue opportunities. Assist departments in pricing current and new services in order to capture all costs and maximize revenue by working with the ChargeMaster manager.
Perform daily analysis by compendium section to identify unusual items - larger or smaller revenue than expected, high dollar charges. Perform daily analysis of late charge reports to determine high volumes by compendium section. Follow up with departments as appropriate when unusual items are noted and ensure problems are resolved and do no recur. Perform monthly detailed analysis of UASI retrospective audit reports and other audit reports used, such as the item master for supply charges, procedure sets to visits, etc., to identify revenue opportunities. Follow up with departments as appropriate and follow through until issues are resolved. Perform a monthly review of the PeopleSoft item file for supplies to ensure that markups are in accordance with CCHMC policies. Perform revenue enhancement projects for management by analyzing and investigating any potential revenue recognition issues. Develop solutions and ensure items are followed up on and resolved. Working with Decision Support to create audit reports for any known issues to ensure they do not recur. As new systems interface into the billing system, audit charges at the time of conversion to ensure that any issues are identified timely and resolved.
·Training and Professional Development
Keep the Business Director training module up to date. Provide training to business directors and their staff related to revenue reports available to them and high level items that they should be monitoring, including late charges. Keep current with changes in coding regulations and maintain licensure.
Skills & Competencies
·Workflow - Advanced
Advanced skills in organizational and workflow efficiency
Locating and gathering relevant information; recognizing and working to eliminate important gaps in existing information; determining the value of the information; synthesizing and organizing information to get a better understanding of a problem
·Excel - Intermediate
Intermediate skill in MS Excel
Proficiency in basic computer applications such as Microsoft Office (Word, Excel, Access), e-mail, and internet
Possess strong organization skills and attention to detail
Effective verbal, written and/or interpersonal communication skills
·Bachelor's Degree in a related field AND Three years of healthcare experience or experience in a consulting role OR Bachelor's degree in Nursing with 5 years professional experience in healthcare finance or consulting experience.
·Experience with financial analysis & knowledge of healthcare reimbursement
·Master of Business Admin OR CPA