logo.png

REVENUE INTEGRITY LEAD SUPPORT SPECIALIST

H. Lee Moffitt Cancer Center

Tampa, FL

Job posting number: #7089349 (Ref:hlj_33931)

Posted: November 17, 2021

Application Deadline: Open Until Filled

Job Description

Position Highlights:

The Revenue Integrity Lead Support Specialist coordinates the priorities among the Revenue Integrity Senior Support Specialists for the the timely completion of the Revenue Integrity Department initiatives and projects. Ensures a consistent charge capture and billing to promote optimal reimbursement by applying appropriate management of Code Correct initiative (CCl)/Outpatient Code Editor (OCE) edits in a timely fashion, coordinating efforts with other areas in the revenue cycle and clinical areas and analyzing the impact of coding changes.

Ideal Candidate:

  • Master’s Degree in Nursing, Finance, HIM/Coding, Healthcare or Business Administration
  • Experience working with Cerner and Soarian applications
  • Experience with coding and Charge Description Master (CDM) maintenance is desirable

Credential and Qualifications:

  • Bachelor’s Degree in Nursing, Finance, HIM/Coding, Healthcare or Business Administration
  • Certified Coding Specialist (CSS), Certified Professional Coder (CPC), or RN Designations (license does not have to be active)
  • Minimum of seven (7) years minimum experience in related healthcare field is required. Related experience may include a combination of clinical (nursing or allied health), coding, provider billing, medical records, charge audit environment, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting
    • In lieu of a Bachelor’s Degree, 12 years of experience in a healthcare provider setting with preference to infusion, radiology, surgery, pharmacy, or laboratory experience, may be considered
  • Experience with Ambulatory Payment Classification (APC) reimbursement, Center for Medicare and Medicaid Services (CMS) rules and regulations, coding and billing compliance

Responsibilities:

Administrative – Coordination of Priorities

  • Reviews, facilitates, and coordinates the timely completion of all priorities assigned to the Senior Support Specialists
  • Maintains relevant documentation up to date and prepares status reports on all assigned priorities

Coding

  • Reviews Correct Coding Initiatives (CCl)/Outpatient Code Editor (OCE) edits for trending analysis and charge capture opportunities
  • Reviews and completes coding for complex edits
  • Analyzes correlation between coding edits and departmental monthly charge reports
  • Review and quantify impact of coding changes before and after implementation
  • Supports timely resolution of issues related to billing, denials and charge capture
  • Maintains the Master Transaction Catalog ( Charges, Service Catalog and Revenue Service Map) in current Financial System

Chargemaster

  • Identify missing/inaccurate charge codes for clinical area of responsibility
  • Works with Manager to optimize process for charge codes updates (add, inactivate)
  • Analyzes root cause of issues related to edits for automation opportunities
  • Works with clinical staff and revenue cycle departments to proactively develop charge codes for new procedures

Special Projects

  • Provide assistance on special projects as assigned
  • Participate on training and educational initiatives regarding clinical documentation to support charge optimization

Other Duties

  • Demonstrated ability to interpret, analyze, develop, direct and implement action to comply with proposed or final Medicare regulations
  • Proficiency with financial data with billing and reimbursement related experience
  • Understands financial management and health care reporting, including the relationship between the Charge Description Master (CDM), charging and cost reporting
  • Demonstrates knowledge of the charge development process and the interrelationship of cost accounting, cost management, decision support and related functions
  • Possesses a working knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), and Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding schemes
  • Possesses a working knowledge of hospital and professional claims forms
  • Understands charging processes and compliance issues and can provide resolutions by performing internet research, utilizing third party payor regulations, referencing coding guidelines, and referencing local Fiscal Intermediary and Center of Medicare and Medicare guidelines
  • Demonstrates knowledge and proficiency of standard PC word processing, spreadsheet, database, and presentation applications (e.g., Word, Excel, Access, PowerPoint) to develop, prepare and analyze statistical reports
  • Excellent project management, problem solving and analytical skills
  • Ability to work independently, identify and resolve problems
  • Excellent interpersonal and communication skills including ability to resolve conflicts with tact and diplomacy, work with all levels of management.
  • Demonstrated knowledge of revenue cycle business processes, including scheduling, registration, documentation, coding, charge entry, billing, collections and reimbursement
  • Direct operations experience in one or more revenue cycle business processes (relevant consulting experience may substitute for operations experience)
  • Ability to maintain patient and compliance information in strict confidence
  • Ability to work with & maintain confidentiality of physician, patient, patient account & personnel data


Mission To create a Moffitt culture of diversity and inclusion as we strive to contribute to the prevention and cure of cancer. Vision Moffitt Cancer Center is recognized as the model wherein the diversity of our employees and communities is valued and supported as essential components to contributing to the prevention and cure of cancer. The cancer center is an equal opportunity employer. It is the policy of the cancer center to prohibit unlawful discrimination and harassment of any type and to afford equal employment opportunities to workforce members and applicants, regardless of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, marital status, disability, genetic information, veteran’s status or any other characteristic protected by federal, state or local law.


Apply Now

Please mention to the employer that you saw this ad on DiversityWork.com

More Info

Job posting number:#7089349 (Ref:hlj_33931)
Application Deadline:Open Until Filled
Employer Location:H. Lee Moffitt Cancer Center
Tampa,Florida
United States
More jobs from this employer
Institution Website
Close menu