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Charge Review Specialist I - Surgery - Tacoma, WA

  • Job ID 1905039926
  • Date posted 10/09/2019
  • Facility Conifer Health Solutions
Description:

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

This job is responsible for ensuring all appropriate billing charges are being captured, documented, charged for the assigned department in accordance with policies and procedures, and applicable regulatory standards and requirements. Focuses on work unit and/or service-line; specifically, surgical department charge reconciliation processes.

ESSENTIAL DUTIES AND RESPONSIBILITIESInclude the following. Others may be assigned.

  • Ensures accurate and timely charge-capture methodologies are in place; reconciles charges against source documents to ensure that charges have been captured completely and accurately; monitors compliance with internal standards and procedures, and reports non-compliance issues to proper authority.

  • Identifies errors and/or omissions, working with appropriate staff/team members to ensure that revisions/corrections forwarded and incorporated in processing systems in timely manner.

  • Provides training to staff engaged in billing data entry and related charge capture/ reconciliation activities to ensure procedures are understood and that charges booked are timely, appropriate, accurate, complete and properly documented.

  • Other duties as assigned could include coordination with CDM team/system, edits/holds, simple report generation.



Qualifications:

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Knowledge of the accepted principles, practices and tools relating to general healthcare billing, cost accounting and reimbursement.

  • Knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting, documentation and general compliance.

  • Ability to recognize, research, and correct charging/documentation discrepancies.

  • Knowledge of the standards and regulatory requirements applicable to matters within designated scope of authority, including medical/legal issues.

  • Working knowledge of medical terminology and abbreviations, and health care nomenclature and systems.

  • Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency.

  • Ability to establish and maintain effective working relationships as required by the duties of the position.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

  • One to three years recent directly related work experience in a healthcare environment or

  • Exposure to healthcare revenue cycle

  • High School graduate or equivalent required

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Must be able to work in sitting position, use computer and answer telephone

  • Ability to travel

  • Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Office Work Environment

  • Hospital Work Environment

Job: Conifer Health Solutions
Primary Location: Tacoma, Washington
Job Type: Full-time
Shift Type: Days