The associate is responsible for timely, accurate and compliant charge capture and billing by daily management of key process indicators for revenue which include assuring all encounters are order-based, coded with payer specific requirements, and contain all charge related revenue appropriate for each encounter within 5 days. This includes tracing the charge back to the point of origin (i.e. system generated charge; flow sheet generated charge; associate generate charge) and developing countermeasure(s) to prevent future occurrences, which includes education at point of work flow failure to reduce denials and missed revenue.
- Responsible for budget associated with billing functions, training of local staff and home office collaborators.
- Attends all charge capture related meetings (e.g. hospital billing, hospital denials) to evaluate documentation and charge gaps in final claim adjudication process.
- Analyzes high-risk encounters for accurate charge capture of all ordered diagnostic tests with focus on Blood Bank, Laboratory, Cardiac Catheterization, Interventional Radiology, Imaging, and Respiratory.
- Teaches, coaches and mentors all billing/Charge capture staff to work collaboratively, accurately and decisively including succession plan rounding with staff.
- Works collaboratively with Compliance, and CBO contributors for any audit reviews upon request.
- Understand complexity of billing requirements and incorporates payer specific trends into day-to-day secondary reviews to reduce “take backs” associated with un-clear, or un-substantiated care rendered.
Reviews all hospital denials to ascertain whether or not services rendered are supported with clear documentation, evidence based logic, and clinical concomitant attributes
- Bachelor's Degree required.
- Minimum of five (5) + years experience required.
- Knowledge of all state and federal regulatory requirements associated with billing, coding and clinical documentation improvement.
- Epic Resolute Certification, Revenue Cycle Certification, Coding Certification preferred.
- Hands on billing and coding experience a must.
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I will provide candidate sourcing, identification and evaluation, in order to place exceptional healthcare professionals together with extraordinary healthcare providers. I have a professional recruiting team that specializes in professional direct hire solutions. I partner with both the client, as well as the candidate to find the ideal professional career fit!
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My expertise is in the following areas:
• Health Information Management
• Revenue Cycle Management
• Behavioral Health
• Inpatient and Outpatient Coding, Billing and Auditing
• Nursing, Nurse Practitioners, Physician Assistants
• Occupational, Speech and Physical Therapists
• Clinical Psychologists, Licensed Clinical Social Workers
• Healthcare Sales, Marketing and Human Resources
• Healthcare Executive placement, i.e. Directors, Chief Nursing Officers, Chief Operating Officers, Chief Executive Officers, Directors of Nursing, Chief Information Officers and all Allied Health Professionals.
It is important that both my client companies, as well as my candidates, are pleased with the service I provide. If both are satisfied, then I have succeeded!My success is due to an outstanding reputation. My customers and applicants know me as organized, ethical, honest, knowledgeable and hardworking. When you partner with me, you are free to concentrate on your core business while I recruit. I spend a great deal of time getting to know you, your company and exactly what you are looking for in an ideal employee.