Revenue Cycle Improvement Coordinator

SUMMARY

Under the guidance of the VP, Revenue Cycle Management, the coordinator independently audits and evaluates the Health System revenue cycle related workflows, identifies problem areas, provides solutions, and assists in the implementation of workflow improvements to assure an effective revenue cycle process. Maintains hospital charge master including participation in the Hospital Pricing Committee, provides recommendations for changes and coordinates the implementation of new/revised charges.

STATUS:  Full-Time               

LOCATION: Riedman Campus          

DEPARTMENT: Revenue Integrity

SCHEDULE: Monday to Friday - ( 8 am - 4.30 pm)      

Minimum Qualifications:

•      Bachelor’s Degree in Business, Accounting, Health Information, other health care related field required.

ATTRIBUTES

• Proficient in utilizing Excel for data analysis, reporting, and visualization.

• Strong ability to interpret data, identify trends, and make data-driven decisions.

• Excellent verbal and written communication skills for interacting with internal teams and stakeholders.

• Familiarity with Epic EHR management and workflows.

• Background in the healthcare industry, with an understanding of medical terminology, CPT/ICD codes, insurance claims, and billing procedures.

• Healthcare experience preferred.

RESPONSIBILITIES

• Maintain an accurate and complete hospital chargemaster (CDM) ensuring competitive pricing, appropriate reimbursement and compliance with governmental billing regulations

• Manage the department chargemasters by scheduling, coordinating, and monitoring departmental CDM reviews and updates. Documents all CDM recommendations.

• Complete the CDM review by obtaining appropriate department head approval, coordinating the effective date and completion of the finalized system changes, and rebilling and/or crediting of services. Report all potential compliance related issues.

• Develop and update CDM Review and charge services policies and procedures including overall health system, standard, and department specific as needed.

• Perform ongoing audits and education to hospital clinical departments on procedures to maintain compliance and integrity of the chargemaster

• Coordinate and monitor all new charge requests (procedures, supplies and pharmacy) including all pre work research, pricing and final approvals.

• Identify, coordinate, and monitor quarterly and annual HCPCS and APC changes.

• Monitor the weekly Department charge Entry Lag Report. Work with department leaders to achieve the health system goal of charge entry with 1-2 days where possible, including performing operational reviews when necessary.

• Identify and report revenue cycle opportunities to the Revenue Cycle Director meeting monthly / annual goals.

• Perform ongoing audits, analyze audit results and create recommendations for optimizing the revenue cycle functions.

• Manages follow up activities to keep revenue cycle initiatives moving forward in a timely manner

• Support financial and administrative oversight of managed care contracts with commercial payers

• Support contracting activities including preparation for negotiation, implementation and analysis of reimbursement performance

• Leads or participates in project teams designed to improve revenue cycle, as needed.

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$62,400.00 - $71,500.00Rochester14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.