FSR III - Pediatric Surgery

DEPARTMENT: Cincinnati Children's Hospital Medical Center

SUPERVISOR'S TITLE: Department Director, Department Manager, Business Director



PURPOSE OF POSITION: To coordinate aspects of professional/departmental billing and/or financial accounting and related day-to-day activities. To proactively identify potential problem areas and find appropriate solutions.

Act in manner that maintains confidentiality, protects and safeguards patient/family personal medical and financial information at all times during collection, use and storage. Access only information and records necessary to perform the responsibilities of your position.
·Billing and Financial Support
Compile and prepare customer charges. Prepare invoices, indicating individual line items for services and total costs. Review and post data. Review computer printouts to ascertain monthly costs, schedule of services completed and type of services performed. Obtain and evaluate family, third party payors and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payors and community physician charges in order to maintain 'usual and customary' as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department.
Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments.
·System Support
Provide Quality Assurance reports for the division. Maintain and update departmental system, including templates and payor and physician information.
·Act as a Department Resource
Act as a preceptor for new employees. Perform specialty services functions. Serve as a resource to coworkers, management, other departments and community contacts. Provide instruction for performing non-routine functions. Participate in departmental/divisional Performance Improvement and Quality Assurance controls. Perform special projects as assigned. May lead and/or train other department members. May fill in for supervisor during supervisor's absence.
·Problem Solving
Troubleshoot systems or non-routine functions. Perform research and analysis.

Skills & Competencies
Using time efficiently and productively; prioritizing multiple tasks properly to meet deadlines; recognizing time constraints and adjusting work schedule to address them.
·Improvement - General
Ability to develop recommendations for improvements
Working cooperatively with others to achieve group goals; proactively adjusting one's style and efforts to complement those of others on the team; being pleasant, agreeable, and easy to work with; valuing group success as much or more than individual success
·Diversity Appreciation
Understanding and showing respect and appreciation for the uniqueness of all individuals; leveraging differences in others' perspectives and ideas; appreciating cultural differences and adjusting one's approach to successfully integrate with others who are different from oneself
Knowledge of ICD-9/10 and CPT Coding
·Computer Proficiency
Proficiency in basic computer applications such as Microsoft Office (PowerPoint, Word, Excel), e-mail, and internet
·Office Equipment
Knowledge of, and the ability to operate, standard office equipment such as computers, telephones, copiers, etc.
·Detail Orientation
Meticulously keeping track of details without becoming overwhelmed by them; being exacting, precise, and accurate; spotting minor imperfections or errors and taking action to correct them
·Independence and Teamwork
Ability to work autonomously, with independent judgment, as well as in a collaborative team environment.
·Problem Solving
Ability to independently work through details of a problem to reach a positive solution
Excellent verbal, written and/or interpersonal communication skills
Knowledge of medical terminology

·High School Graduate OR Equivalent plus one of the following: (1) documented completion of professional coding certification, OR (2) completion of an Associates or Bachelor's degree, OR Equivalent combination of education and experience OR (3) completion of 18 contact of continuing education within the last three years
·Five years previous exp: 5 years of experience at CHMC performing level I and II work, 7 years of exp external to Cincinnati Children's performing level I and II work