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Charge Auditor, Lead –Revenue Integrity – Maitland in Maitland, FL at Adventist Health System

Date Posted: 12/8/2018

Job Snapshot

  • Job Schedule
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Function
    Other Non-Clinical Professional
  • Travel
  • Shift
  • AHS Zone
    2-Legacy System
  • Organization
    Florida Hospital

Job Description

Charge Auditor, Lead –Revenue Integrity – Maitland

Maitland seeks to hire Charge Auditor, Lead who will embrace our mission to extend the healing ministry of Christ.

Facility Profile:

Established in 1908, Florida Hospital is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.

Department Profile:

The Revenue Integrity Department works collaboratively with all Revenue Cycle Department’s. The department focus is to ensure the integrity and compliance of the hospital’s revenue stream. This responsibility is achieved by performing patient charge audits, denials and appeals management, Local and National Coverage Decision management, and ensuring that the clinical systems and process are in place for charge capture.

Work Hours/Shifts:

Mon – Fri / 8a -5p

Job Summary:

Under general supervision, the Revenue Integrity Lead Charge Auditor supports the operations of the charge auditing team by ensuring timely and accurate charge audit reviews while ensuring adherence to local, state, and federal compliance guidelines. Provides team members with tools, training, and support needed to assist in meeting accuracy and productivity goals, minimizing errors, rejections and denials via use of the charge capture audit system. Uses clinical knowledge and billing experience to compare the medical records documentation to patient account charge detail pertaining to individual items billed. Identifies and communicates trends of missing or misdirected charges to management to resolve charge capture related issues. Performs supervisory duties in the absence of the manager. Adheres to Florida Hospital Corporate Compliance Plan and to the rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Knowledge, Skills, Education, & Experience Required:

  • Minimum of three years’ experience in healthcare, with specific emphasis on revenue cycle billing, charging, coding, finance or related
  • Ability to work and meet deadlines in a fast-paced, dynamic, project-oriented environment through organization and time management skills
  • Comprehensive understanding of CCI edits, CPT, HCPCS, ICD, and revenue codes
  • Knowledge of Medicare, Medicaid, third-party billing rules, coverage, payment, and compliance
  • Ability to read medical charts or dictation, understand services performed, and correlate those services to charges on the bill (UB92)
  • Self-motivated, detail-oriented focus, and outstanding customer service skills
  • Effective verbal and written communication skills
  • Computer skills to include MS Office, Windows operating system, Internet, and ability to navigate through electronic health record systems
  • Associate’s degree in healthcare or coding-related program (Preferred)
  • Minimum of three years’ hospital clinical or nursing experience (Preferred)
  • Knowledge of Florida Hospital Information Systems, including Suncare and Cerner (Preferred)
  • Knowledge of FH Chargemaster system and the impact changes in pricefiles have on the FH clinical departments and revenue cycle (Preferred)
  • Basic understanding and ability to navigate in DDE (online Medicare billing) (Preferred)
  • Knowledge of PFS Registration, PFS Billing processes, HIM Coding, and Chargemaster (Preferred)

Licensure, Certification, or Registration Required:

  • N/A
  • Registered Health Information Administrator (RHIA), (Preferred)
  • Registered Health Information Technician (RHIT), (Preferred)
  • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) (Preferred))
  • Current active Florida State license as a registered nurse (Preferred)

Job Responsibilities:

Demonstrates through behavior Florida Hospital’s Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization’s Performance Excellence Program

  • Responsible for assignment and monitoring of work flow by retrieving the RMAU/related reports and distributing/re-distributing work based on volumes and staffing. Assigns staffing coverage to ensure timely completion of all work lists in an effort to meet Revenue Integrity department goals. Works as part of the team to cover critical peak periods and assists with workloads as needed.
  • Performs routine quality audit reviews of the Charge Auditors to ensure minimum accuracy, providing education, feedback, and working with manager to coach employees as needed.
  • Monitors productivity of Charge Auditors to ensure department standards are achieved, identifying any barriers and assisting manager with helping employees achieve goals.
  • Remains knowledgeable and current on all regulations to help support compliance and maintain integrity, serving as a resource to employees and customers of the Revenue Integrity department. Applies new knowledge to daily work duties while effectively communicating and continuing education.
  • Proactively works to identify, evaluate, and resolve charge or information system opportunities, recommending changes to ensure system’s reliability and data integrity, working effectively with Clinical Liaisons. Identifies and communicates trends of missing or misdirected charges to management to resolve charge capture-related issues.
  • Assists in providing continuing education to employees. Trains and assists new hires to ensure they successfully meet the 90-day productivity/accuracy standards.
  • Accountable for maintaining a close working relationship with all Revenue Cycle Departments to ensure open communication. Escalates any unresolved/outstanding charge issues to the manager as needed for prompt resolution. Maintains understanding of how clinical and operational changes impact the Revenue Cycle.
  • Is available to front line staff for daily questions, work assignment, coaching, and support. Provides management oversight in the absence of the manager.

If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Charge Auditor, Lead opportunity with Maitland and apply online today.

Job Keywords:

Charge Auditor, Revenue Integrity, Finances

Position Location:  Maitland
Job:  Other Non-Clinical Professional
Organization:  Florida Hospital
Primary Location:  US-FL-Maitland
Schedule:  Full-time
Shift:  Day
Job Level:  Team Leader
Education Level:  None
Travel:  No
Job Posting:  Oct 8, 2018, 12:44:23 PM

Location | Organization | Category | Job Function