Centura Health connects individuals, families and neighborhoods across Colorado and western Kansas with more than 21,000 of the most talented hearts and minds in medicine.
Through Centura Health's 17 hospitals, two senior living communities, health neighborhoods, physician clinics, Flight for Life® Colorado, home care and hospice services, we offer a diverse range of work settings in a Colorado or Kansas community you will love to call home.
Enjoy amazing people, competitive pay, some of the best benefits in the industry and plenty of opportunity for professional growth and development.
If you're ready to discover the difference of working for a fully-integrated health system with a non-profit, faith-based mission to care, we look forward to receiving your application.
Job Description/Job Posting ID: 96235
Acts as a resource person to Charge Audit and Hospital staff; monitors and directs daily interventional activities interrelated with a variety of revenue generating reports and requests. Serves as a liaison to Patient Financial Services, Health Information Management, Information Technology, and Compliance areas and facilities as they relate to charging and documentation practices, and patient account billing compliance requirements. Provides collaborative relationship in development, testing, and implementation and maintenance of hospital revenue generating systems; charge capture and reconciliation processes; overall technical service Charge Master File maintenance; and Clinical Charge Audits of patient accounts in follow-up to patient/insurance requests. Performs all duties as RAC Coordinator, manages all processes with regard to regulatory audits, education, compliance, billing and corrective action plans. Provides updates and education, with regard to RAC activity and changes in government regulations, to senior management. Implements provider and staff education to increase billing compliance. Oversees the process of surgery schedule reviews and collection of therapy notes for total joint procedures with regard to pre-payment DRG case review.
Minimum Education Requirements
High School Diploma or GED required Bachelor's Degree or 10 years healthcare experience in related area.
Minimum Experience Requirements
5 years related experience in Charge Audit, Medical Records and Patient Accounting 1 year Supervisory Experience
Position Duties (essential functions denoted with an * )
Ensure a quality Charge audit department by helping establish and utilize Policies and Procedures.*
Oversees the work of the Charge Audit Staff to assure that audits are done in a timely fashion to promote prompt payment of Insurance Claims.*
Oversees CDM analyst and ensures individual is accurately trained to maintain CDM, assist managers, and audit charging processes. Reviews new CDM requests and approves.*
Determine root causes of charging issues identified during billing edits and work with service line managers or CDM analyst to resolve.*
Ensure timely RAC audit review and processing of denied accounts to remain within all the regulatory timelines.*
Motivates, trains, and evaluates the staff of the Department.*
Assessing employee and department needs to enhance and improve productivity and work standards.*
Provides collaborative relationship in development, testing, and implementation and maintenance of hospital revenue generating systems; charge capture and reconciliation processes; overall technical service Charge Master File maintenance; and Clinical Charge Audits of patient accounts in follow-up to patient/insurance requests.*
Works collaboratively with Centura Health RAC Team to process RAC requests and appeals.*
Works with physician/s to understand both RAC compliance issues and inpatient/outpatient status requirments.*
Trains service line departments and their designees on charge master responsibilities and on-going governmental regulation changes and additions.*
Serves as a consultant to managers on revenue compliance issues and mediator with corporate recommendations on such issues.*
We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people of our communities.
It is essential that associates be able to support the values of Centura Health and interact effectively with physicians, patients, residents, visitors and staff. Each associate is expected to demonstrate a commitment to core values, standards of behavior and professionalism through appropriate conduct and demeanor at all times.
CORE VALUES and STANDARDS OF BEHAVIOR
Integrity: Honesty, directness, and respect for commitments made. Stewardship: Respectful use of all natural, human and financial measures. Spirituality: Acknowledgment of its central role in facilitating mental, physical and emotional health. Imagination: Creativity and innovation in all we do. Respect: Respect for all persons and our Christian identity, heritage and missions of our sponsoring organizations. Excellence: Striving to exceed the clinical quality, customer service and cost performance expectations of our customers. Compassion: Sensitivity and responsiveness to persons in need.
SECURITY ACCESS: CONFIDENTIAL INFORMATION
Staff may have access to confidential patient, associate and/or organizational information as it applies to their job responsibilities and must comply with the terms of Centura Health policies in protecting that information.
Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V.