Job Description

Inspire health. Serve with compassion. Be the difference.

Coordinates timely, comprehensive charge reconciliation for Perioperative Services. Performs internal charge audits and assists supervisor in overseeing the Chargemaster for assigned enterprise-wide departments. Coaches staff regarding coding and billing issues. Reviews escalated accounts and issues providing coding expertise.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.

• Performs audits intraoperative logs for Perioperative Services to include surgery, recovery, and anesthesia. Reviews nursing/anesthesia documentation and operative notes to assure timely, complete, and accurate billing of supplies, implants, and facility fees for assigned areas of responsibility. Assigns appropriate CPT codes based on surgeon documentation according to CMS CPT Guidance. For device dependent procedures, assures all device charges have been captured.

• Performs internal charge review audits and documents audit findings as directed. Supports Periop Revenue Integrity Charge Specialists in identifying and resolving complex cases, answering questions, and providing education to same. Assists the Periop Coding Analyst to resolve specific charge capture issues with the Perioperative charge team and other departments to include Revenue Integrity, Patient Accounts and HIM.

• Follows established departmental guidelines and consistently, appropriately, and proactively notifies nurses, anesthesia staff and physicians of both documentation and charge capture deficits and issues needing clarification. Documents follow-up to assure timely resolution and in support of both documentation and revenue cycle integrity.

• Provides research and analysis of accounts in assigned Epic work queues and from other departments. Uses knowledge of billing and coding conventions and CMS rules and regulations to analyze and resolve account issues. Aids with editing and correcting of failed claims related to coding by reviewing charts to verify supplies/implants/devices used and appropriate codes assigned.

• Oversees the maintenance of CDMs in departments of responsibility. Assists in determining if items are chargeable and identifies appropriate coding to include revenue and HCPCS codes. Identifies and corrects supplies and implants that need item numbers and charge codes.

• Performs other duties as assigned.

Supervisory/Management Responsibilities

• This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

• Education - High School diploma or equivalent OR post-high school diploma / highest degree earned. ​Associate degree preferred.

• Experience - Three (3) years of relevant experience in healthcare, charge capture and/or revenue cycle.Experience in hospital operating room preferred.

In Lieu Of

• NA

Required Certifications, Registrations, Licenses

• CCS, CPC, RHIA, or RHIT certification

Knowledge, Skills and Abilities

• Ability to use Microsoft office suite

• Working knowledge of medical terminology, anatomy and physiology.

• Working knowledge of ICD9-CM, CPT/HCPCS and UB04 codes

• Knowledge of office equipment

• Proficient computer skills (word processing, spreadsheets, database)

• Data entry skills

• Mathematical skills

Work Shift

Day (United States of America)

Location

5 Medical Park Rd Richland

Facility

7001 Corporate

Department

70016169 Perioperative Administration

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.