Works to improve the accuracy, integrity, and quality of patient charges and ensure minimal variation in charging practices.
Collaborates with Revenue Cycle and clinical departments to perform high-level analysis of governmental and commercial payer regulations related to authorization, coding, and billing guidelines. Maintains current knowledge of coding guidelines, billing regulations, and regulatory agency activities.
Serves as the primary liaison for clinical service lines regarding payer guidelines and revenue integrity. Identifies charge edit trends, reviews charge capture and Charge Description Master processes, supports workflow improvements, and helps reduce claim edits and rejections. Prepares meeting materials, facilitates revenue cycle meetings, and assists with charge master review, education, and training.
Bachelor's or associate degree in Health Information Management, Business Administration, Accounting, Management, or Healthcare Administration.
Must hold and maintain one or more of the following credentials: RHIA, RHIT, CCS, or CPC. AAHAM or HFMA certifications are preferred.
Five years of experience in a hospital setting or within the healthcare industry is strongly preferred. 1-3 years of experience related to auditing and/or coding is required.
Knowledge of Medicare/Medicaid regulations, billing, coding, and documentation requirements. Understanding of reimbursement systems including IPPS, OPPS, and fee schedule.
Strong oral and written communication skills. Ability to research, analyze, and interpret healthcare policies, billing guidelines, and state/federal regulations. Strong organizational, project management, time management, and attention-to-detail skills. Ability to mentor and work effectively in a team environment.
Comprehensive benefits package for full-time and part-time colleagues, including:
- Medical insurance, including prescription coverage
- Supplemental insurance
- Dental insurance
- Vision insurance
- Life and AD&D insurance
- Short- and long-term disability
- Flexible spending accounts
- Retirement plans
- Tuition assistance
- Voluntary benefits and group insurance discounts
- Tuition discounts at Thomas Jefferson University after eligible service
- Medical insurance available to all colleagues, including part-time and per diem staff
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$65,054 - $92,701
Remote work allowed
No
Posted
5 days ago