Essential Functions

Serves as a revenue cycle subject matter expert and identifies root cause of revenue leakage.Collaborates with clinical staff and IAS regarding charging functionalityIdentifies charging opportunities by analyzing current processes and preparing relevant reports regarding trendsOptimizes reimbursement by reviewing and coordinating with clinical staff and deliver recommendations for improvement.

 

Monitors changes made to the Charge Description Master.Reviews and studies all information from third-party payors on claims filing, coding, and the adjudication process.Studies, reports, and makes recommendations regarding compliance concerns.Works with coding personnel to ensure that codes on the CDM are accurate and current.Works with Information Systems personnel to make certain the CDM information is placed correctly in the system.Analyzes revenue and reimbursement data to maximize financial improvement opportunities.Oversees maintenance of VitalWare application request workflow, reports and logs.

Physical Requirements
May Lift and move reports and notebooks weighing up to ten pounds. Ability to work under pressure to meet deadlines. Majority of day is spent sitting.

Education, Experience and Certifications

High School Diploma or GED required. CPC or CCS certification and at least 4 years ICD-9 and CPT coding experience preferred. Experience with or exposure to Epic/Encompass billing system (chargemaster specific) and Epic CDM Certification preferred.