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Perioperative Charge Capture Specialist

2 months ago

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

Overview:
This role involves the meticulous entry of billing invoices specifically for Spine and Orthopedic services into the Peoplesoft system. It includes the assessment and reconciliation of surgical charges within the Cerner platform that contribute to overall revenue generation. Additionally, this position entails the entry of Anesthesia facility charges and conducting Revenue Audits.
I Key Responsibilities:

Records all charges associated with Perioperative hospital services, including Surgery, Endoscopy, and Anesthesia. Conducts audits, compiles, summarizes, and submits necessary documentation to the Anesthesia professional billing service. Accountable for the audit, verification, and entry of billing for supply charges and implants related to perioperative services, generating essential balance sheets and invoices. Reviews account adjustments to ensure accuracy and procedural compliance. Performs daily revenue reconciliation and prepares monthly internal audit reports for the Finance department. Additional responsibilities include the entry of all critical data elements recorded during procedures for accurate reporting.

II Position Requirements:

A. Education


•Completion of two years of college coursework in a medically related field or equivalent professional experience to acquire knowledge of medical terminology, anatomy/physiology, and familiarity with medications, abbreviations, and procedural charges.

B. Licensure / Certification Not Applicable

C. Skills and Aptitudes
  • Exceptional customer service skills necessary for effective interaction with various levels of hospital personnel, external customers, and vendors. Ability to recognize and prioritize individuals in high-pressure situations.
  • Proficient understanding of medical terminology with the ability to accurately spell medical terms. Capable of typing at least 30 corrected words per minute.
  • Requires the ability to balance accounts and a solid understanding of claims processing, payments, and adjustments.
  • High work volume necessitates strong mathematical and analytical skills to reconcile accounts and resolve issues related to contractual payments, discounts, and outstanding balances.
  • Proficient in keyboarding and computer skills, with expertise in Microsoft Office Suite and Mainframe data entry. Ability to interpret data and generate reports using various software applications.
  • Ability to operate standard office equipment (e.g., fax, calculator, copy machine).
  • Excellent customer service orientation skills necessary for effective interaction with various levels of hospital personnel, external customers, and community groups.
III Experience:

  • Three to five years of experience in patient accounting or managed care, with a preference for perioperative operations.
  • A minimum of six months of experience in perioperative billing is preferred.
  • Prior experience in posting cash and adjustments within a healthcare environment is preferred.
IV Duties and Responsibilities:

Ensures all transactions comply with federal, state, and hospital regulations. Reviews account adjustments for accuracy and procedural integrity, reporting any identified trends or issues to the supervisor. Generates daily and monthly audit reports to address revenue discrepancies. Analyzes and reports trends to ensure appropriate payments are received. Provides input for performance improvement indicators. Conducts quality reviews and documents findings as required. Supplies data, reports, and documentation related to managed care issues, adjustments, and credit balances. Enters, verifies, and audits patient charges and post-operative data promptly and accurately. Confirms with Patient Accounting and Third-Party vendors that patient charges have been successfully transmitted and processed. Collaborates to ensure the accuracy of supply and charge information on departmental records. Communicates needs to the Business Manager as necessary. Maintains current knowledge of all organizational compliance policies and procedures and performs duties accordingly. Upholds confidentiality regarding all patient, department, hospital, and other sensitive information. Secures documents and information to ensure confidentiality. Works closely with System Specialist and Surgery Revenue Lead to reconcile all revenue issues within the Surgery System.
  • Demonstrates and actively promotes an understanding and commitment to the mission of Trinity Health through behaviors consistent with the organization's core values.
  • Maintains a working knowledge of applicable federal, state, and local laws and regulations, as well as the Trinity Health Organizational Integrity Program, including the Standards of Conduct and Code of Ethics, to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
  • Conducts oneself in a manner consistent with customer service expectations.
  • In accordance with departmental practices, ensures that appropriate charges are entered for the correct patient, encounter, and date/time of service, making corrections as needed per charge capture policies.
  • Actively participates in ongoing education and communication regarding revenue management as per departmental practices.
  • Assists with tracking and monitoring of equipment assigned to the unit, requesting maintenance services as needed.
  • Proficient with electronic health records for documentation, assessment, and care management, performing these activities concurrently with care provision throughout the shift.
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.