Works to improve the accuracy, integrity, and quality of patient charges while ensuring minimal variation in charging practices. Partners with Revenue Cycle and clinical departments to analyze payer regulations related to authorization, coding, and billing guidelines. Maintains current knowledge of coding guidelines, billing regulations, and regulatory agency activity.
Primary clinical service-line liaison for payor guidelines, regulatory requirements, and revenue integrity workflows. Serves as a subject matter expert for clinical departments on revenue cycle issues. Identifies charge edit trends, completes focused charge reviews, supports charge capture workflow improvements, reviews Charge Description Master change requests, facilitates revenue cycle meetings, and helps develop education and training related to chargemaster review.
Bachelor's or associate's degree in Health Information Management, Business Administration, Accounting, Management, or Healthcare Administration.
Must hold and maintain one or more of the following credentials:
- RHIA
- RHIT
- CCS
- CPC
Preferred certifications from AAHAM or HFMA.
Experience and qualifications:
- 1–3 years of experience related to auditing and/or coding required
- Five years of experience in a hospital setting or healthcare industry strongly preferred
- Knowledge of Medicare/Medicaid regulations, billing, coding, and documentation requirements
- Understanding of reimbursement systems including IPPS, OPPS, and fee schedule
- Ability to research, analyze, and interpret healthcare policies, billing guidelines, and state/federal regulations
- Strong oral and written communication skills
- Strong presentation, organizational, project management, time management, and follow-through skills
- Attention to detail and ability to work collaboratively in a team environment
Comprehensive benefits package for full-time and part-time colleagues, including:
- Medical (including prescription)
- Dental and vision insurance
- Supplemental insurance
- Life and AD&D insurance
- Short- and long-term disability
- Flexible spending accounts
- Retirement plans
- Tuition assistance
- Voluntary benefits and insurance discounts
- Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service
Location
Philadelphia, Pennsylvania, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 week ago