Trinity Health Supervisor Central Charge Control in Ft. Lauderdale, Florida
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices and decisions.
Ensures organizational compliance specific to federal guidelines and Regional/Trinity Health policies and procedures specific to revenue integrity and revenue cycle operations:
- Works directly with the Revenue Integrity and Optimization leader to mitigate any compliance risks in a timely and efficient manner in accordance with the organization's compliance program and healthcare billing/coding guidelines issued by the Center for Medicare & Medicaid Services or any other regulatory body.
- Tracks risk exposure incidences and calculate the financial impact based upon approved processes designed to resolve/reduce compliance risks and reports them to the appropriate persons based upon organizational policies.
Identifies and develops focused approach to ensure appropriate charge capture:
- Ensures proper charge capture practices are implemented consistently across the organization
- Develops and implements operational processes to ensure timely and accurate charge entry for supported services in an efficient and effective manner that assist in the reduction of charge capture related denials
- Conducts quality and productivity reviews to ensure appropriate and accurate charging practices are in effect.
- Takes appropriate action based upon quality and productivity reviews to return the team's performance to best practice standards including operational, scheduling and personnel changes as needed.
- Oversees continuing education efforts for colleagues as needed based upon on billing and charging processes guided by coding, compliance and regulatory guidelines specific to their services.
- Works with clinical leadership as needed to make certain all revenue cycle related needs for a clinical department are met.
- Works with all areas of the revenue cycle process including coding and billing to resolve issues as needed.
Routinely evaluates and documents the charge capture, revenue reconciliation and charge error management process for each department and identifies process improvements.
Collaborates with the Revenue Integrity and Optimization leader on Charge Description Master (CDM) changes that may be needed for compliant charge capture.
Monitors Medicare and Medicaid web sites, as well as payer websites and newsletters for changes impacting charging, coding and billing.
Prepares and provides education to departments and staff based upon audit findings, regulatory changes and requirements, coding updates, and managed care billing requirement changes.
Develops colleagues work schedules to ensure cost effective staffing that meets customer requirements and quality performance. Supervises team projects and fosters interdisciplinary and intra department collaborative relationships.
Provides guidance and direction to assigned staff to ensure service integration, effective coordination of departmental work activities, and quality job performance. Provides feedback in a prompt, direct and positive manner; mentors and coaches colleagues to ensure positive outcomes. Provides counseling and/or conflict resolution regarding performance matters
Elicits feedback from interdisciplinary team, including the medical staff, and involves them in decision-making as appropriate.
May be responsible for hiring employees and recommending allocation of resources Monitors and conducts performance appraisals, including review and approval of performance goals, provides regular ongoing performance feedback including disciplinary actions.
Analyzes and displays data in meaningful formats; develops and communciates policies/procedures and other business documentation; manages and conducts special studies and prepares management reports, including Key Performance Indicators as they relate to the department.
Other duties as assigned.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Must possess a comprehensive knowledge of Hospital and/or Physician Practice operations and a minimum of three (3) years of progressively responsible experience in revenue cycle operations, including charge capture, revenue optimization revenue cycle consulting or an equivalent combination of education experience. Associate's degree preferred. Supervisor or Team Leader experience preferred.
Licensure / Certification: RHIA, RHIT, CCS, CPC/COC or other coding credentials strongly preferred. CDC (Healthcare Compliance Certification) preferred.
Knowledge and experience in charge capture and control in an acute care and/or Physician Practice setting.
Previous Charge Description Master (CDM) practical experience preferred.
Strong knowledge of CPT, UB Revenue Codes, ICD-10-CM codes and related regulatory and compliance guidelines.
Understanding of Diagnosis Related Group(DRG), Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures preferred.
Knowledge of laws and payer contracts governing billing of hospital and/or physician services.
Demonstrated ability to effectively work with a diverse group of people which includes physicians, clinicians, office managers, administrators, third party payers, governmental agencies and colleagues.
Ability to understand and interpret complex issues and clinical processes and recommend improvements.
Experience with data collection, analysis, and providing written reports, proposals, incorporating findings.
Job Number: 00169177
Location: Ft. Lauderdale, FL
Organization Name: Holy Cross Hospital
Facility: HCHFL - Holy Cross Hospital
Employment Type: Full time