Job Description

Revenue Process Specialist

PRN/OCC, Variable Hours per pay period

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.

Coordinates and performs charging of emergency department visits provided within Covenant. Work involves analyzing physician and nursing documentation, determining appropriate charges, identifying documentation issues, and resolving issues identified by the business office due to claim edits or modifier needs. Maintains all organizational and professional ethical standards.

Responsibilities

• Reviews physician and nursing documentation to determine charges for services by using standard definitions and applying regulatory guidelines for coding, charging and billing.
• Identifies areas of opportunity with physician and/or nursing documentation for compliant optimal department revenue as well as identifying areas of risk from a lack of documentation representing the services provided. Analyzes documentation for key elements to capture documentation deficiencies in order to provide the respective department leaders with the usable information to identify and improve documentation.
• Works in conjunction with the business office and/or health information management to resolve claims issues related to the charging or modifier assignment.
• Performs routine departmental monitoring to maintain an acceptable level of compliance relating to charging. Works closely with co-workers to identify process improvements and opportunities for the team related to accuracy. Takes appropriate action to follow through with corrections to the account.
• Consistently maintains volumes of charge output above acceptable minimal threshold (determined annually by trend of department average).
• Effectively uses and monitors the compliance of electronic tools used to determine the appropriate charges. Utilizes resources available appropriately, i.e. use of Covenant Health equipment and/or supplies.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as requested.

Qualifications

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing an Associate's degree in a directly-related field from an accredited college or university.

Minimum Experience:

One (1) year of experience in charging, coding, or billing required.

Licensure Requirement:

None