I. JOB SUMMARY: • Monitors charge capture and charge reconciliation outcomes. • Reviews, develops, implements, evaluates, and revises charge guidelines to optimize revenue management; effectively implements recommendations and monitors results. • Identifies charge compliance issues and root causes of noncompliance. Ensures correction of issues and develops changes to workflow processes to ensure that issues are prevented in the future. • Ensures operations and functions are in compliance with regulatory requirements and policies and procedures of QHS. • Prepares and presents financial reports for executive management review.
II. TYPICAL PHYSICAL DEMANDS: A. ESSENTIAL FUNCTIONS: • Seeing. Hearing. Speaking. Finger dexterity.
B. MANUAL MATERIAL HANDLING: • Infrequent: N/A • Occasional: N/A • Frequent: N/A • Constant: N/A
C. NON-MANUAL MATERIAL HANDLING: • Infrequent: N/A • Occasional: Stand. Walk. Stoop/Bend. Reach: shoulder level. • Frequent: N/A • Constant: Sit.
III. TYPICAL WORKING CONDITIONS: • Not substantially subjected to adverse environmental conditions.
IV. MINIMUM QUALIFICATIONS: A. EDUCATION: • Bachelor's degree required, preferably in business administration, finance or health care administration; or four (4) years of experience in healthcare finance or related field such as business services or revenue integrity may be substituted for the education requirement.
B. CERTIFICATION AND LICENSURE: • No certification/license requirement.
C. EXPERIENCE: • In addition to the education requirement, three (3) years of experience in revenue integrity, coding, charge capture or billing compliance, preferably in a comparable organization. • Experience to demonstrate the following: o Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting. o Knowledge of requirements specific to government-funded health care program and third-party payer reimbursement. o Proficiency with computer-based hospital billing/records applications and Microsoft Office applications, i.e. Word and Excel. • Prior experience with Epic systems preferred.
Equal Employment Opportunity
Equal Opportunity Employer / Disability / Vet
Numbers & Facts
Location
Aiea
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Skills
Billingunmatched
Billing Recordsunmatched
Business Administrationunmatched
Business Servicesunmatched
Charge Captureunmatched
Chargemasterunmatched
Computer Skillsunmatched
Epic Systemsunmatched
Financeunmatched
Financial Reportingunmatched
Government Fundingunmatched
Government Requirementsunmatched
Healthcareunmatched
Healthcare Administrationunmatched
Healthcare Reimbursementunmatched
Hospitalunmatched
Identify Issuesunmatched
Maintain Complianceunmatched
Manual Dexterityunmatched
Medical Billingunmatched
Medical Codingunmatched
Microsoft Excelunmatched
Microsoft Officeunmatched
Microsoft Wordunmatched
Physical Demandsunmatched
Reconciliationunmatched
Regulatory Complianceunmatched
Regulatory Requirementsunmatched
Revenue Analysisunmatched
Revenue Managementunmatched
Third-Party Payerunmatched
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