Job Title:
Revenue Integrity Charge Specialist
Employment Type:
Full-Time
Shift:
Days
(SUMMARY) Position Highlights:
Competitive payAdditional Benefits: tuition reimbursement, free parking, employee discountsQuality of Life: Flexible work schedulesAdvancement: professional growth within the organizationLocation: Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD.Responsibilities:
Responsible for ensuring accurate CPT/HCPCS documentation for the patient billing process and educating colleagues and ancillary departments in accurately documenting services performed and using appropriate codes representing those services.Responsible for charge capture in Revenue Integrity assigned areas.Review's chart, including nursing notes, physician orders, progress notes, and surgical or specialty notes thoroughly to interpret and validate and/or extract all charges.Verifies charges captured on the correct patient, correct encounter, correct date of service, with any required modifiers.Review's documentation, abstracts data and ensure charges/coding are in alignment within AMA and Medicare coding guidelines.Performs coding functions, including CPT, ICD-10 assignment, documentation review and claim denial reviewResponsible for working the pre-bill edits within key metrics, including but not limited to OCE/CCI, & DNFB.Provides “at-elbow support” to ancillary departments including but not limited to; ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.Performs charge entry, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity.Responsible for coding and/or validation of charges for more complex service lines, advanced proficiencies in surgical or specialty coding practice.Educates clinical staff on need for accurate and complete documentation to ensure revenue optimization and integrity.What you will need:
Associate’s degree in healthcare, business administration, finance, accounting, or related field or equivalent experience considered in lieu of degree.RHIA, RHIT, CCS, CPC/COC, AAPC or other coding credentials requiredMinimum three (3) years of relevant coding and charge control work experience in a hospital and/or Physician Practice environment and experience in revenue cycle, billing, coding, and/or patient financial services.Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes & modifiers), charging processes & audits, & clinical billingWorking knowledge of third-party payer rules & requirements, computer operations & electronic interfaces related to charge documentation, capture & billing is required.Knowledge of charge capture, reconciliation, error management operations & overall revenue cycle operations required.Pay Range- $25.17 - $35.23
Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.
About us:
Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties — Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services. We were named one of America’s 100 Best Hospitals for 2021.
Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.