What are the responsibilities and job description for the Revenue Cycle Director position at Appling Healthcare?
Duties and responsibilities:
- Analyze and resolve billing edits that require clinical expertise and are holding patient claims from billing, by reviewing medical records and other applicable documentation.
- Maintain the integrity of facility Charge Description Master (CDM) and Revenue Integrity Systems Program by incorporating new charges and services identified by the departments, third party changes, special requirements, and/or coding updates.
- Maintain the integrity of all Ancillary Department systems related to billing and revenue.
- Identify charging, coding, or clinical documentation issues and work with ancillary departments to resolve issues and notify appropriate leadership.
- Review, develop, implement, evaluate, and revise charge guidelines to optimize revenue management; effectively implement recommendations and monitors results.
- Serve as liaison between Administration, the PAS and Ancillary Department Directors regarding revenue and compliance issues.
- Coordinate all retrospective, concurrent, patient complaint and external billing audits and provide monthly audit results. Reviews all Medicaid, Medicare/CAHABA Billing Compliance correspondence and adheres to all guidelines.
- Develop and coordinate educational in-services to the Business Office staff and Ancillary staff related to charging and billing issues.
- Review denial trends for documentation or charging issue opportunities.
- Review high charge stays/procedures for charging accuracy.
- Ensure unbilled items are addressed properly and timely.
- Serve as primary contact for all charge-related PAS inquiries and issues.
- Good interpersonal skills.
- Able to establish good customer relationships with trust and respect.
- Computer skills: navigation and edit resolution through various Web based systems, Ability to use email, Excel, Word.
- Knowledge of CPT, HCPCS, ICD-9 coding.
- Maintain confidentiality at all time in accordance with Protected Health Information (PHI)
Education/ Qualifications:
Bachelor of Business Administration
Experience:
Healthcare experience required.
1 to 2 years Management experience
Physical Demands:
Employee is required to both sit and stand for prolonged periods of time. Will be required to lift up to 25 lbs. Bending, stooping, are all frequently done in a workday. The ability to think and work under stress, to tolerate being subjected to frequent interruptions, and be will willing to work beyond normal working hours as necessary. Requires communication ability (speak, read, comprehend, and write) and strong interpersonal skills to work with physician offices, CBO employees and Financial Services employees
Working Environment:
Works in a climate controlled office setting.
Equipment:
Ability to use Office Equipment.
EOE STATEMENT
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
