Audit and Revenue Cycle Integrity Coordinator (Remote)

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Entity: Corporate
Department: Fin Mgmt Patient Acct Admin
Location: Penn Medicine Hospice- 150 Monument Road
Hours: 8hr Days (Remote)

Summary:

Responsible for performing charge capture audits, initiating and leading performance improvement efforts to enhance charge capture, educating clinical departments, and promoting revenue cycle integrity.

Responsibilities:

• Ensure contracts are followed and correct reimbursement is received for Transplants, Implants, Organs, Factor and Carve-Outs. This includes identifying implants that otherwise would not be paid due to (missing) charge postings, HCPCS mis-assignment, non-procurement of manufacturer’s invoice, mis-registration, wrong diagnosis and procedure codes, etc. Enhance the ability to increase revenue through targeted claims analysis, identifying systematic errors in registration, coding and prices that affect revenues.
• Identify and communicate missing or incorrect charge submission to appropriate clinical or administrative personnel in Ancillary departments.
• Review Third Party Payor Audits and prepare a defense when third parties do not follow industry standards or do not comply with contractual obligations.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
Other duties as assigned to support the unit, department, entity, and health system organization

Credentials:

• CCS or CPC (Required)
• Certified Procedural Coder - CPC (AAPC) or Certified Coding Specialist - CCS (AHIMA)

Education or Equivalent Experience:

• H.S. Diploma/GED (Required)
• And 5 years previous work experience in medical billing (Required)
• Bachelor of Arts or Science (Preferred)
• Requires working knowledge of reimbursement methodology and procedures, CPT and ICD codes, Medicare and Medicaid regulations. (Required)

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.