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Category: Nursing
Facility: 1. Dayton Children's
Department: HOD Business Management
Schedule: Full Time A (80 hrs pp.)
Shift: Day Shift
Hours: 8-4:30
Job Details: Bachelor's Degree
Ohio Nursing License

Responsible for supporting Dayton Children's goals for reimbursement through the coordination of compliance activities including ongoing audits of charges by review of itemized bills and medical record documentation. Utilizes a clinical and financial approach to determine appropriateness of billing, uncovering data entry or pricing errors; unbundling; inappropriate, unsubstantiated or improper charges; reviews observation times, infusion charges, experimental/investigational reviews; and other practices that inflate billed amounts.  Routinely performs audits of charges on randomly selected accounts assessing for charge capture opportunities and error prevention. Communicate missed charges and documentation issues to appropriate staff/departments and provide education on methods for improving documentation and revenue enhancement as well as education on regulatory compliance issues.  Work closely with billing specialists, H.I.M. staff, and ancillary departments.  Demonstrates understanding of federal, state and professional regulations regarding coding practices. A Bachelor’s degree, pediatric patient care experience, Ohio RN license, Computer skills (Excel, Word, PowerPoint and EPIC), communication skills and customer service skills required. A Master’s degree and coding and/or billing experience preferred.

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