- Works with Revenue Cycle owners to maintain clean, accurate charges and billing for compliance and revenue maximization purposes.
- Identify interdepartmental process flow problems, makes suggestions for positive changes and develops action plans to implement these improvements.
- Ensures that CPT/HCPCS codes, revenue codes and billing information is accurate and correlated, and that the information in the charge master conforms with overall organizational billing practices.
- Initiates and develops relationships with customers in order to gather and process information or resolve issues in order to receive accurate reimbursement and optimize internal and external customer satisfaction.
- Shows competencies in CPT and HCPCS coding, reimbursement guidelines surrounding all payors
- Provides guidance and support of charge integration between various systems (Star, PMM, Epic).
- Assists Business owners in resolution of issues with billing, denials, coding and reimbursement.
- Reviews daily claim edit reports and develops and executes a work plan to identify key billing and CDM issues.
- Performs regular reviews of order entry screens, charge capture sheets and UB92 charges to ensure proper flow of charges and compliance with regulatory changes.
- Continually works to identify processes by which to recognize potential areas for lost revenue.
- Holds regular meetings with key users and departmental personnel to discuss project plans, time lines, issues and status of systems.
- Coordinates the scheduling, delivery, testing and implementation steps associated with software fixes, and/or customizations for assigned areas.
- Documents progress, resolution and time spent on all activities in the appropriate tracking system."