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Department: Emergency Department
Status: Part Time
Shift: Days
Hours Per Shift: 8 Hour Shift
Job Details:
    • Job Objective: A brief overview of the position.
      • This Revenue Specialist position is primarily responsible for the daily, timely and accurate Charge Capture and Charge Reconciliation processes.
    • Reports to
      • Revenue Recognition Manager and Payor Relations Director
    • Supervises
      • N/A
    • Ages of Patients
      • Neonate/ Infant
      • Pediatric
      • Adolescent
      • Adult
      • Geriatric
    • Blood Borne Pathogens
      • Minimal/ No Potential
    • Qualifications
      • Education
        • Preferred: Some College
      • Licensure/Certification
        • N/A
      • Experience
        • Required: Minimum 5 years of hospital / clinical experience in charge capture, billing processes
    • Essential Responsibilities
      • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
      • Responsible for the daily, timely and accurate Charge Capture and Charge Reconciliation processes.
      • Performs all charge functions in STAR as they relate to charge capture and reconciliation audit processes by utilizing appropriate revenue cycle tools to maximize collections
      • Performs daily audits of the charge capture process utilizing all revenue journals, reports, schedules, Pre-Billing work lists, failed claims and other identified revenue processing tools for assigned departments
      • Checks the accuracy and completeness of patient type and visit status on patient account. Works with PFS and Access Services to amend patient account accurately and appropriately for visit of service
      • Functions as a liaison between the Revenue Recognition team, Charge Master, Payor Relations and PFS to assist assigned department directors in the establishment and periodical review of their charge structures and charge rates to be consistent with all regulatory and compliance standards, regional and local market shares and EMC contracts
      • Assists assigned departments director/managers in identifying, communicating and implementing new SIM's or corrected SIM'S due to updated regulatory and compliance notifications. Reviews department’s Charge Master, charge structure of revenue generating departments to assure that charges are accurately reflect services, supplies and productivity and are compliant and consistent of current industry accepted practices
      • Works with hospital directors to develop, identify and implement charge capture and reconciliation tools to track and trend processes for purpose of analysis to identify potential areas of lost revenue
      • 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
      • Assists Revenue Recognition Manager in identifying areas of process improvement through various audits, chart reviews, and other methods of review
      • Performs other duties as assigned.

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