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Cerner Millennium will be the source system for scheduling and registration workflows, prior authorization, financial counseling, point of service collection, eligibility, health information management/medical records, coding, charge capture for both professional and facility billing, follow-up, customer service, claim generation, denials management, and cash posting.
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This position is responsible for reviewing, auditing and reporting on charge capture at the department level, completing charge reconciliation, analyzing and resolving claims’ denials and unbilled claims' issues, performing audits on department patient accounts, supporting Revenue Integrity initiatives on behalf of the department, and ensuring billing compliance.
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Works with revenue integrity, finance and clinical leadership to develop, implement charge capture entry, validation, reconciliation and correction processes; developing and implementing protocols, policies and procedures to support charge capture accuracy and timeliness.
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Documents lessons learned and works with colleagues in Revenue Integrity department on creating standard charge capture and process reference materials. Ability to communicate effectively with other departments, including leadership, for the areas of charge capture, HIM, PBS and other key stakeholders.
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I.e., charge capture, patients accounting, customer service, coding appropriate modifiers, etc and collections)Maintaining a current understanding and working knowledge of insurance plans.
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Coordinates with clinical operations, revenue cycle departments to ensure accounts audited reflect proper documentation, charge capture, coding, billing and payment. Coordinates and executes pre- and post-payment audits of medical records and associated clinical documentation to ensure proper charge capture and billing in accordance with standard state, federal, and internal reimbursement policies, principles, and mandates.
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Contributes to the identification and reduction of the Company’s coding compliance risks, billing inaccuracies, and/or denials by coordinating independent reviews and assessments of the organization's professional coding and billing transactions, processes, and internal controls for coding completeness and accuracy.
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Masters use of clinical systems to ensure efficient and excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders.
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Monitors the front end revenue cycle performance for the site, including but not limited to demographic and insurance capture, charge capture, coding trends, open encounters, denial trends, and copay collection rates.
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Ensures clinical workflows to optimize patient capture, processing of referrals and scheduling. Keywords: Physical Therapy: Physical Therapist | PT | Physical Therapy | Orthopedic Physical Therapist | Rehabilitation Therapist | Sports Physical Therapist | Outpatient Physical Therapist | Sports Medicine Therapist | Clinical Director of Physical Therapy | Lead Physical Therapist | Outpatient Orthopedic Therapy.
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Manage revenue cycle activities to attain performance benchmarks related to credentialing, charge capture optimization, claim rejection & denial rates, DSO (Days Sales Outstanding), and overall collections.
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Masters use of clinical systems to ensure efficiency, excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders.
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Maintains revenue integrity by monitoring all inpatient and outpatient charge capture reports and work lists for services and supplies rendered. Position Summary: We have an exciting opportunity to join our team as a Specialist, Clinical Charge Capture.
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Participate in provider education on proper documentation of services provided, coding and billing issues, charge capture process and reconciliation of charges as it relates to E&M coding guidelines.
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Provides PHS Enterprise guidance, communication and education on correct charge capture, coding and billing processes. Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payor requirements.
Full-timeExpandApply NowActive JobUpdated 6 days ago
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