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Charge Capture Analyst/Periop

2 months ago

Pontiac, United States Trinity Health Full time
Employment Type:
Full timeShift:
Day Shift

Description:
Demonstrate a thorough understanding of department charges/charge order set(s), department CDM, and charge capture processes for all surgical patients and works collaboratively with other departments to accomplish accurate charge captures. Entry of bill only invoices and Anesthesia facility charges, along with evaluation and reconciliation of surgery charges in EPIC that drive revenue and perform revenue audits.
I Accountability Objectives:

Records charges for all Perioperative hospital services including Surgery, Endoscopy and Anesthesia. Audits, collates, summarize and submits documents/charting to the Anesthesia professional billing service. Responsible for audit, verification and entry of billing of supply charges and implants for perioperative services generating balance sheets and invoices. Reviews account adjustments for accuracy and procedural integrity. Performs revenue reconciliation on a daily basis and provides monthly internal audit reports to Finance. Addtional entry of all key data elements recorded from procedure for reporting purposes.

II Position Qualifications:

Minimum Education, Licensure / Certification and Experience Required.

A. Education

•Two years college course work in a medically related discipline or equivalent work experience in order to gain knowledge of medical terminology, anatomy/physiology, familiar with medications, abbreviations, chemical symbols, charge for procedures.

B. Licensure / Certification Not Applicable

C Special Skill / Aptitudes
  • Excellent customer service orientation skills necessary in order to deal effectively with various levels of hospital personnel, outside customers and vendors. Ability to recognize and prioritize people in stressful situations.
  • Working knowledge of medical terminology and ability to spell medical terms correctly. Able to type 30 corrected words/minute.
  • Work requires the ability to balance accounts and knowledge of claims processing, payments, and adjustments.
  • Work volume is high, and involves math and analytical skills to reconcile accounts and resolve issues with contractual payments, discounts and outstanding balances.
  • Excellent keyboarding and computer skills with proficiency in Microsoft Office Suite and Mainframe entry. Ability to interpret data and extract reports using various software programs.
  • Ability to operate general office equipment (ie: fax, calculator, copy machine).
  • Excellent customer service orientation skills necessary in order to deal effectively with various levels of hospital personnel, outside customers and community groups.
II Position Qualifications:

Minimum Education, Licensure / Certification and Experience Required.

D. Experience
  • Three to five years of patient accounting or managed care experience. Perioperative operations preferred.
  • Minimum 6 months perioperative billing preferred.
  • Previous experience posting cash and adjustments in health care setting preferred.
III Duties / Responsibilities:

Ensures all transactions are consistent with federal, state and hospital requirements. Reviews account adjustments for accuracy and procedural integrity. Reports any identified trends or problem areas to supervisor. Generates daily and monthly audit reports to reconcile revenue issues. Measures and monitors various aspects of revenue cycle processing and documents. Analyzes and reports trends to ensure appropriate payments are received. Provides input for performance improvement indicators selected. Performs quality review and documents findings as requested. Provides data, reports and documentation relative to managed care issues, adjustments, and credit balances. Measures and monitors various aspects of revenue cycle processing and documents findings for review. Enters, verifies and audits patient charges and post-operative data in a timely and accurate manner. Verifies with Patient Accounting and Third-Party vendors that patient charges have been successfully transmitted and processed. Collaborates to ensure that supply and charge information on departmental records are correct. Communicates needs to Business Manager as needed. Maintains current knowledge of all organizational compliance policies and procedures and performs duties accordingly. Maintains confidentiality of all patient, department, hospital and other information. Secures documents and other information to ensure confidentiality. Works closely with System Specialist and Surgery Revenue Lead and Finance to reconcile all revenue issues within the Surgery System.
  • Demonstrates and actively promotes an understanding and commitment to the mission of St. Joseph Mercy Oakland through performing behaviors consistent with the Trinity Health Values.
  • Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behaviors.
  • Supports and conducts one's self in a manner consistent with customer service expectations.
  • In accordance with unit or departmental practice, determines that appropriate charges have been entered for the correct patient, encounter, date/time of service, with any required modifiers. Make corrections as needed per charge capture policy/practice.
  • In accordance with unit or departmental practice, actively participates in on-going education and communication regarding revenue management.
  • In accordance with unit or departmental practice, assists with tracking and monitoring of equipment assigned to the unit. Requests services for maintaining equipment as needed.
  • In accordance with unit or departmental practice, proficient with the electronic health records for documentation, assessment, and care management, performing these activities concurrently with provision of care throughout the shift.


IV Dept/Unit Specific:

Not Applicable

V Working Conditions:

•Normal office environment.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.