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Periop Revenue Charge Specialist, PRN

Company: Palmetto Health
Location: Greenville
Posted on: June 12, 2021

Job Description:

Inspire health. Serve with compassion. Be the difference.

Job Summary

Ensures complete and accurate revenue integrity charging standards for Perioperative Services for IP/OP surgery centers. Follows compliant charge capture program and billing practices in accordance with Medicare, Medicaid or Third Party payor guidelines.

Accountabilities

Daily audits charges and enters facility fees for Perioperative Services into the Perioperative Information system to include surgery, preop, and recovery. Analyzes relevant nursing documentation and encounter forms to identify descrepancies in order to accurately capture all revenue. Enters or credits all implant and supply charges as required into the OPTIFLEX and Demand bill systems assuring accurate and completes charge capture. - 35%

Performs daily audits of revenue cycle charge proof reports and Bipas against surgeon's operative note and all other nursing documentation to assure timely, complete and accurate billing for compliance and maximum reimbursement within AR timelines. Reviews procedures for appropriate CPT codes based on all documentation to assure correct facilty fee. The auditing process includes accesssing multiple down stream systems for compliant charge capture and documentation intergrity. - 30%

Follows established department guidelines and consistently,appropriately and proactively notifies nurses of errors in both documentation and charge capture for correction and clarification to assure both documentation and revenue cycle integrity. - 10%

Daily records clinical charge errors discovered through detailed audits processes into department access data base to provide RN Perioperative Business Services documentation necessary in the development of in-services and one on one coaching for the clinical staff. - 10%

Monitors, researches and responds to periodic billing problems for Perioperative Services including identifying supply/implants needing item and charge numbers and for CCA and Xclaim inquiries. Follows up and resolves problems in a timely manner communicating effectively with coworkers, nurses and management staff.RN Perioperative Business Services. For late charges, follows established protocols. - 10%

Assists RN Perioperative Business Services and Manager in annual review of department policies and procedures. Assumes additional projects as assigned by management. - 5%

Supervisory/Management Responsibilities

This is a non-management job that will report to a supervisor, director or executive.

Minimum Requirements

High school diploma or equivalent

Minimum experience - 3 years; Health Care Revenue Cycle

Required Certifications, Registries, Licenses

NA

Optional

In lieu of the experience and/or educational requirements indicated above a combination of education, training, and/or experience will be considered an equivalent substitution: Coding certification from an accredited organization: AAPC, AHIMA or ACMCS or (5) years in a health care facility or physician office practice to include working knowledge of ICD9-CM, CPT/HCPCS,UB-04 revenue codes and /or denials or (5) five years in Health Information Management with working knowledge of ICD9-CM,CPT/HCPCS.

Other Required Skills and Experience

Basic Computer Skills

Knowledge of office equipment (fax/copier)

Proficient computer skills (word processing)

Proficient computer skills (spreadsheets)

Proficient computer skills (database)

Data Entry

Mathematical Skills

Other: Typing

Other Qualifications or Experience

Working knowledge of medical terminology, anatomy, physiology. Which can be obtained by on-the job training or through college courses. - Preferred

Familiarity with ICD9-CM, CPT/HCPCS and UB04 codes - Preferred

CPC to be obtained 2 years after date of hire - Preferred

Additional In Lieu of Statement

Team members employed in this job prior to July 1, 2020 are grandfathered under prior educational and experience requirements. In addition, team members must be certification eligible and will have one year to obtain required certification(s).

Work Shift

Day (United States of America)

Location

Greenville Memorial Med Campus

Facility

1008 Greenville Memorial Hospital

Department

10086169 Perioperative Administration

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Keywords: Palmetto Health, Greenville , Periop Revenue Charge Specialist, PRN, Other , Greenville, South Carolina

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