Revenue Integrity Charge Capture Coordinator

The Revenue Cycle Charge Capture Specialist is  responsible for ensuring that all hospital and professional charges are captured and posted to patient accounts in an appropriate, compliant, and timely manner in accordance with M Health Fairview Revenue Cycle Charge Capture Policy’s required timeframe of 24 hours after the date of service or discharge and that charges are adequately supported by clinical documentation and orders as appropriate.  Identifies, analyzes, and reconciles billing errors or missed charging opportunities. Facilitates and supports charge reconciliation training and processes to ensure accurate and timely charge entry, reduction of late charges and escalation of charging issues or open encounters. Works edits and errors within the charging systems, and trends data to identify risks, root cause resolution and opportunities for continuous performance and quality improvement.

This position is eligible for benefits!

Some of the benefits we offer at Fairview include medical insurance - as low as $0, dental insurance - also a $0 option, PTO (24 days per year starting), and a 403B with up to a 6% employer match; visit www.fairview.org/benefits to learn more and get all the details.

• Collaborates with clinical department staff and managers, IT analysts and Compliance staff to ensure charges are applied correctly through the system, contributing to the process of collecting expected payment for services provided.
• Acts as a liaison for clinical departments and revenue cycle leadership to address charge related questions or concerns. Promotes opportunities for continuous process improvement and works with department leadership to implement workflow changes as necessary.
• Supports functions of hospital and professional charge capture, charge reconciliation, and associated workflows through training, education, and monitoring.
• Develops custom charge capture educational materials for leaders and all clinical provider types
• Serves as an active participant in the ongoing education to physicians, clinical departments, service line leaders, charge champions and staff on proper usage or orders-based charging and charge codes.

Monitors and works assigned account, charge review, claim edit, charge router review, and charge router error poolwork queues. Identifies missed revenue and suggests improvements to ensure timely and accurate clean claim billing.

• Maintains a solid understanding of medical records, coding, hospital charging, billing competency and compliance to all Federal, State, and Local regulations.
• Utilizes reporting resources to monitor KPIs such as open encounters, missing charges, late charges, and reporting to ensure that billing departments are performing daily charge reconciliation, all according to policy.
• Conducts routine audits of hospital and professional charges of all service lines to ensure complaint charging.

• Recommends system configuration and revenue guardian edits to prevent commonly missed charging scenarios.
• Understands and adheres to Revenue Cycle’s Escalation Policy.

• Meets or exceeds quality and productivity standards set by direct supervisor or manager.

• Other job duties as requested.

Organization Expectations, as applicable:

• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.

• Partners with patient care giver in care/decision making.
• Communicates in a respective manner.
• Ensures a safe, secure environment.
• Individualizes plan of care to meet patient needs.
• Modifies clinical interventions based on population served.
• Provides patient education based on as assessment of learning needs of patient/care giver.

• Fulfills all organizational requirements.
  • Completes all required learning relevant to the role.
  • Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures, and standards.
• Fosters a culture of improvement, efficiency, and innovative thinking.
• Performs other duties as assigned.

Required Qualifications

• Associate Degree in related healthcare field, or two years of experience in Revenue Cycle related work.
• Two years of applicable Revenue Cycle experience

Preferred Qualifications

• Associate Degree in Health Information Management or related healthcare field, or 5 years applicable experience in Revenue Cycle related work
• Five years of applicable Revenue Cycle experience
• Knowledge of Rev codes, HCPCS, CPT codes
• Coding certification through American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), or National Association of Healthcare Revenue Integrity (NAHRI)