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Revenue Integrity has become a leading national focus to gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue Integrity in an integral part of the Revenue Cycle and covers all essentials related to it. We have teams comprised of Charge Capture, Pre-bill, Post-bill and Monitoring (Auditing). RI also utilizes technology to enhance achievement along with an added focus where necessary that may include high dollar accounts, denials, improved A/R days and cash flow while collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement
The Senior Charge Specialist will be responsible for assigning appropriate billing codes for acute care, periop, or outpatient unit(s), clinic(s) or medical office(s) system-wide. They will work from daily queries and any compliance related audit.
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Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
POSITION SUMMARY This position assigns appropriate billing codes for acute care, periop, or outpatient unit(s), clinic(s) or medical office(s) system-wide. Evaluates medical records, provider notes and dictation to determine appropriate procedure codes to assign to patient records and bills. Uses coding software and the company's Charge Description Master (CDM) to create billings and charges for insurers, government agencies and other payors. Researches coding for non-standard procedures and assigns codes in accordance with nationally recognized coding guidelines and company standards.
CORE FUNCTIONS 1. Audits daily error reports in both the coding and billing system and makes corrections. Matches, corrects and codes charges that do not drop to billing. Also responsible for working daily monitoring queries that capture errors prior to billing as well as individual requests from the CBO or HIMS. As assigned shares this information with clinical charging staff.
2. Reviews patient records, dictated report(s), physician/provider notes. Uses a standard listing of procedures/charge codes and/or an automated system with the company's programmed Healthcare Common Procedure Coding System (HCPCS) for all commonly used Diagnosis Related Groups (DRGs).
3. Researches and assigns codes for non-standard procedures, supplies, equipment or materials.
4. Researches missing and incompatible records information supplied by medical staff, transcriptionists, suppliers and others. Assures that all appropriate items, procedures and services are recorded and appropriately billed. Acquires medical record completion as required by national coding standards.
5. Identifies opportunities for improvement in clinical documentation. Provides guidance and education for staff in billing procedures and electronic medical records usage procedures for coding and billing requirements. Maintains a current knowledge of procedural terminology requirements and provides staff with updated information on reimbursement charges and documentation requirements. As assigned, develops and provides education for physicians and staff.
6. Works with company finance and Charge Description Master (CDM) teams to develop and maintain coding and billing database information and with other point of service charging/coding staff to maintain consistency in practice. As assigned, shares this information with clinical charging staff.
7. Works as a member of the system team to provide services and achieve goals. As assigned, may manage supply chain functions, scheduling, provide patient services or administrative support.
8. Works independently under regular supervision. Researches complex billing issues and makes necessary corrections to achieve expected reimbursement. Uses structured work procedures and independent judgment to solve problems and achieve high quality levels. Work output has a significant impact on system business goal attainment. Customers include physicians, nurses, physician office staff, third party payors, central billing staff, staff from other departments and patients/patient families.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.
MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge.
Requires a level of knowledge normally gained over four or more years of related work in the same type of clinical, medical office or acute care unit. Must be knowledgeable of medical terminology and current regulatory agency requirements for coding and charging for the assigned clinical area, and have a good understanding of reimbursement methodologies. Requires strong abilities in researching, reading, interpreting and communicating, as well as effective interpersonal skills, organizational skills and team working abilities.
Must be able to work effectively with common office software, coding and billing software, and the electronic medical records system.
PREFERRED QUALIFICATIONS Current Procedural Terminology (CPT) coding experience in a similar setting and Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) credentials preferred for some assignments.
Additional related education and/or experience preferred.
Internal Number: R6793
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.