Clinical Reimbursement Specialist

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Work schedule: This is a fully remote position

PRIMARY PURPOSE

Responsible for reviewing charges and identifying discrepancies for assigned area(s) and working with other departments in order to make necessary corrections. Assures charges are posted in a timely and accurate manner.

MINIMUM SPECIFICATIONS

Education

• Associate's degree from a Registered Health Information Technician accredited program or Associate's degree in a health care related field preferred.

Experience

• Must have five (5) years of hospital or medical office or related experience to include three (3) years of experience with charge capture, charge review, medical billing, registration, and/or coding.

Equivalent Education and/or Experience

• May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

Certification/Registration/Licensure

• Certified Coding Associate (CCA) of Certified Professional Coder (CPC), or Registered Health Information Management Technician (RHIT) preferred.

Skills or Special Abilities

• Must pass the General Computer test with a minimum score of 80%

• Must be able to demonstrate knowledge of Electronic Medical Record (EMR) software applications

• Must have strong analytical skills and organizational skills and be detail oriented

• Must have knowledge of CPT and ICD-9 coding

• Must have effective written and oral communication skills

• Must have the ability to convey ideas and communicate effectively and to clearly present concepts of charge entry to clinical end users

• Must be customer service oriented.

Responsibilities

• Reviews applicable clinical documentation and data in EPIC applications to assure charge capture matches clinical documentation.

• Assists in the management/reconciliation of patient accounts with charge discrepancies by researching issues and working with Patient Financial Services to make account adjustments in a timely manner. Ensures complete and accurate information is provided for billing to ensure revenue is maximized.

• Generates and distributes routine and periodic reports for management on charge capture errors.

• Provides training to departmental employees and serves as a resource person in charge capture.

• Maintains a positive working relationship with customers, management, vendors, and other hospital employees to ensure and open/friendly environment for effective communication.

Job Accountabilities

• Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.

• Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.

• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.