Charge Capture Analyst - Revenue Integrity_QHS (Full-Time, 40 Hours, Day Shift)

RESPONSIBILITIES

I. JOB SUMMARY:

• Monitors charge capture and charge reconciliation outcomes.

• Reviews, develops, implements, evaluates, and revises charge guidelines to optimize revenue management; effectively implements recommendations and monitors results.

• Identifies charge compliance issues and root causes of noncompliance. Ensures correction of issues and develops changes to workflow processes to ensure that issues are prevented in the future.

• Ensures operations and functions are in compliance with regulatory requirements and policies and procedures of QHS.

• Prepares and presents financial reports for executive management review.

II. TYPICAL PHYSICAL DEMANDS:

A. ESSENTIAL FUNCTIONS:

• Seeing. Hearing. Speaking. Finger dexterity.

B. MANUAL MATERIAL HANDLING:

• Infrequent: N/A

• Occasional: N/A

• Frequent: N/A

• Constant: N/A

C. NON-MANUAL MATERIAL HANDLING:

• Infrequent: N/A

• Occasional: Stand. Walk. Stoop/Bend. Reach: shoulder level.

• Frequent: N/A

• Constant: Sit.

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION:

• Bachelor's degree required, preferably in business administration, finance or health care administration; or four (4) years of experience in healthcare finance or related field such as business services or revenue integrity may be substituted for the education requirement.

B. CERTIFICATION AND LICENSURE:

• No certification/license requirement.

C. EXPERIENCE:

• In addition to the education requirement, three (3) years of experience in revenue integrity, coding, charge capture or billing compliance, preferably in a comparable organization.

• Experience to demonstrate the following:

o Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting.

o Knowledge of requirements specific to government-funded health care program and third-party payer reimbursement.

o Proficiency with computer-based hospital billing/records applications and Microsoft Office applications, i.e. Word and Excel.

• Prior experience with Epic systems preferred.

Equal Opportunity Employer/Disability/Vet