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Eisenhower Health · 4 months ago

Revenue Cycle Analyst/Coder

Eisenhower Medical Center

Full-time

Onsite

Entry, Mid Level

$23.97/hr - $36.42/hr

2+ years exp

Eisenhower Health is a medical center focused on providing quality healthcare services. The Revenue Cycle Analyst/Coder is responsible for performing revenue cycle integrity audits and ensuring compliance with coding guidelines while providing guidance to staff on charge capture and billing processes.

Health CareHospitalMedicalOutpatient CareRehabilitation

Responsibilities

Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations

Performs audits of all revenue generating departments’ CDM files, conducts departmental interviews to ensure proper recording of transactions and compliance with state and federal coding guidelines relating to the charge capture and billing of services

Provides guidance, communication and education to department and clinic staff on correct charge capture, current charging structure, billing and coding processes by the elimination of duplicate, inactive or non-compliant charges incorporating state and federal guidelines

Prepares and submits audit findings to leadership to review and compile recommendations

Assesses the accuracy of charge capture tools (i.e. forms, charge screens, charge stickers and other charge capture tools) and recommends appropriate changes to meet these standards

Reviews facility bill rejection reports to correct, edit or apply appropriate modifiers to charges for compliant billing practices, as appropriate

Examines reports, and makes recommendations regarding deficiencies in controls, duplication of effort, fraud, or lack of compliance to leadership

Provides assistance to all hospital department charge custodians to assist in completing their department identified bill rejection charges

Maximizes collection through recognition of terms and conditions of EMC’s payor contracts. To present recommendations to Director of Payor Relations regarding terms and conditions and charge increases with consideration of improving payments from third party payors

Acts as liaison between Revenue Recognition team, Charge Master, Payor Relations and PFS to assist revenue generating department leadership in the establishment and periodical review of charge structures and charge rates to be consistent with all regulatory and compliance standards, regional and local market shares and EMC contracts

Assists leadership in identifying areas of process improvement, system enhancement and actively engages in a process improvement committee representing the role in any integrated hospital process improvement team

Performs other duties as assigned

Qualification

Certified Professional CoderMedical billing experienceCharge capture knowledgeFinancial analysis proficiencyResearch skillsInterpersonal relationsProblem-solving abilityWritten communicationVerbal communication