Charge Representative, Revenue Integrity
Company: St. Joseph's Health
Posted on: January 16, 2020
Responsible for maintaining documentation regarding charge capture
processes including technology components and personnel
interactions to allow for organizational clarity & accountability.
Performs regular reviews of process adherence and identifies
missing charges. Works with other key stakeholders regarding
impacts of system change requests and upgrades on charging
processes to ensure continued capture accuracy. Provides oversight
of reconciliation processes for all assigned departments; ensuring
daily and appropriate monthly reconciliations are occurring.
Handles charge entry, charge approvals, and/or charge reviews for
identified service lines; including but not limited to, appending
modifiers and checking clinical documentation.
As a mission-driven innovative health organization, we will become
the national leader in improving the health of our communities and
each person we serve. By demonstrating reverence, commitment to
those who are poor, justice, stewardship, and integrity, our
organization will continue to provide better health, better care,
at lower costs.
Knows, understands, incorporates, and demonstrates the Trinity
Health Mission, Vision, and Values in behaviors, practices, and
Reviews chart, including nursing notes, physician orders and
progress notes thoroughly to interpret and validate and/or extract
all charges. Ensures each chart is complete according to specified
guidelines. Ensures charges captured on the correct patient,
correct encounter, correct date of service, with any required
Performs daily reconciliation processes including ensuring supply
charges are appropriate captured (may include implants), identify
duplicate charges and initiate appropriate communications when
there are documentation and/or charge deficiencies or charge
Reviews documentation, abstract data and ensure charges/coding are
in alignment with in AMA and Medicare coding guidelines.
Reviews charge capture lags and charge error management and ensures
timely attention to departmental assigned charge errors. Reports
repetitive charge discrepancies to leadership.
Compares charges to clinical/medical record documentation while
ensuring compliance and regulatory requirements are met. Educates
clinical staff or other stakeholders on need for accurate and
complete documentation to ensure revenue optimization and
Maintains a minimum productivity standard, based on service line
and charge type; including but not limited to, chart review, charge
extraction, E&M level assignment and charge entry.
Documents lessons learned and provides feedback to Revenue
Integrity department to create standard charge capture and process
reference materials. Assists with project initiatives to deploy
information and provide education.
Reviews and respond to various quality reports, including reports
that identify missing charges, duplicate charges, late charges,
etc. Maintain and update required reference logs and other
reporting tools. May create and present information for decision
Attends coding and reimbursement workshops and webinars;
communicates related information to appropriate departments and
ensures understanding and assists with applicable process or system
changes as needed.
May perform research on charges and communicate findings to intra
and inter-departmental colleagues.
Other duties as assigned.
High school diploma or equivalent combination of education and
Minimum of one (1) to two (2) years of relevant work experience in
a Hospital and/or Physician Practice environment and experience in
revenue cycle, billing, coding and/or patient financial services.
Charge control/capture work experience strongly preferred.
Knowledge of medical terminology, data entry, supply chain
processes, hospital and/or Medical Group practice operations.
Knowledge of Hospital and/or Physician group practice revenue cycle
front-end functions such as patient registration that may impact
charge related errors.
Ability to organize and to prioritize work in a diverse, fast-paced
environment while working on multiple projects simultaneously.
Knowledge of billing and regulatory guidelines related to charging
and other revenue cycle processes and ability to assist clinical
departments and/or physician practices with changes to their
charging practices based on guidelines.
Experience with MS Excel, Word and PowerPoint preferred. Epic
Must be comfortable operating in a collaborative, shared leadership
Must possess a personal presence that is characterized by a sense
of honesty, integrity, and caring with the ability to inspire and
motivate others to promote the philosophy, mission, vision, goals,
and values of Trinity Health.
Maintains a working knowledge of applicable Federal, State, and
Local laws and regulations, the Trinity Health Integrity and
Compliance Program, including the Code of Conduct, as well as other
policies and procedures in order to ensure adherence in a manner
that reflects honest, ethical and professional behaviors.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
This position operates in a typical office environment. The area is
well lit, Temperature controlled and free from hazards.
Incumbent communicates frequently, in person and over the phone,
with people in all locations on product support issues.
Manual dexterity is needed to operate a keyboard. Hearing is needed
for extensive telephone and in person communication.
The environment in which the incumbent will work requires the
ability to concentrate, meet deadlines, work on several projects at
the same time and adapt to interruptions.
Must be able to set and organize own work priorities and adapt to
them as they change frequently. Must be able to work concurrently
on a variety of tasks/projects in an environment that may be
stressful with individuals having diverse personalities and work
Ability to thrive in a fast-paced, multi-customer environment, with
conflicting needs which some may find stressful. May warrant varied
and/or extended hours, with changes in workload and priorities to
keep pace with the industry and advance strategic priorities.
The above statements are intended to describe the general nature
and level of work being performed by persons assigned to this
classification. They are not to be construed as an exhaustive list
of duties so assigned
Keywords: St. Joseph's Health, Syracuse , Charge Representative, Revenue Integrity, Other , Syracuse, New York
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