Revenue Integrity Coordinator

This position is responsible for documenting and communicating the charge capture practices for Renown Health System. The coordinator is also responsible for managing the relationships with clinical leadership responsible for charge capture and reconciliation, establishing standard work and organizational charge capture timeliness goals. The coordinator is also responsible for coordinating with vendors who participate in chart audit functions and CDM maintenance at Renown Health.

This position will be responsible to:

a. Regular meetings with revenue producing departments to review, validate, and assist them in documenting their current charge practices. Checks to ensure practices are in line with regulatory billing and compliance guidelines.

b. Provide flow charts and other documentation for all current charge practices for all revenue producing departments

c. Keep issues log of findings/issues/action plans for the revenue producing departments.

d. Escalates any charge errors discovered to the Charge Error Correction Team and respective processes and standard work for charge error correction.

e. Provides training based on findings/issues/action plans as directed for the revenue producing departments.

f. Represent Renown Health to chart audit vendors who are either on site or remotely auditing clinical records for appropriateness of charges based on documentation.

g. Assist with on boarding new business entities and affiliated sub-licensee facilities to EPIC charge master, charge processes and reconciliation. Specifically, providing guidance and direction to Information Technology and Operational leaders of the new business entities regarding department configuration in Epic to ensure the integrity of the revenue generated by the new business entities.

h. Assist internal and external customers with new charge requests or changes, maintaining responsibility for all charge practices within Renown Health’s electronic medical record platform

i. Communicate CDM updates and changes in industry charging requirements to clinical leaders, Revenue Cycle leadership, and Finance.

j. Review departmental work queues to ensure departmental compliance.

k. Review, analyze, interpret and provide charge practice expertise as part of the New Service and Product request process. Collaborate with Contracting, Reimbursement subject matter experts, and Finance in order to produce ROI analysis for New Service and Product requestors.

l. Provide support and oversight to the Revenue Integrity Specialists, helping to attain needed feedback from clinical leaders to resolve claim edits or other stop bill processes to ensure claims can be submitted appropriately.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelor's Degree required. Experience may be substituted on a year for year basis.

Experience:

Minimum of five (5) years' experience in hospital finance or in patient financial services with knowledge of charge description master and charge capture processes.

Demonstrated customer service orientation, strong people/interpersonal skills, and with direction, ability to work on multiple projects.

CPT, ICD-10-CM and HCPCS and medical terminology experience preferred as well as charge capture processes in Epic (either charge capture or clinical documentation).

Understanding of clinical charge practices, billing rules and claims processes

Excellent oral and written communication skills. Excellent presentation skills.

Computer literacy, including word processing, spreadsheet applications, database management and graphics experience.

License(s):

None

Certification(s):

None

Computer / Typing:

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Access, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.