ProFee Charge Review Specialist
Employment Type:Direct Hire
REMOTE POSITION AVAILABLE
Position under minimal supervision, the incumbent utilizes clinical and/or coding expertise to enhance revenue integrity by performing concurrent or retrospective charge capture audits for Professional Fee related charges/coding. These audits/edits compare medical record documentation to the itemized bill in accordance to governmental, coding and billing rules and regulations to identify opportunities for improved compliance and revenue opportunities through more effective documentation or improved charge capture processes. Actively participates in compliance activities as required to assure revenue integrity.
Maintains a working knowledge of the revenue cycle process to aid in the implementation of regulatory standards while accurately complying with billing guidelines. Participates in ongoing coordination and resolution of revenue issues as they arise. Analyzes audit results to identify patterns, trends, variances and opportunities to improve revenue integrity. Coordinates with other Revenue Integrity team members and other departments as necessary to ensure identified patterns and trends are provided as feedback to improve revenue integrity going forward. Works assigned work queues to effectively manage charge audit issues and resolve issues in a timely fashion. Ensures audits are conducted accurately and timely to minimize delays in billing and eliminate potential denials or compliance related issues.
· Three (3+) or more years of relevant experience i.e. Professional Fee Coding and Epic
· Certified Professional Coder (CPC).