ED Revenue Integrity Specialist II, Remote

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** Primary

Location:

** Work From Home - KY - UMC#
** Address:
** Home Office Remote, KY 40601#
** Shift:
** First Shift (United States of America)#
** Job Description

Summary:

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*
* Job Description:

** This position is responsible for performing daily revenue integrity audits and charge reconciliation to support the accurate and timely capture of Emergency Department (ED) charges. Daily monitoring of patient board and review of census and discharges to ensure that required documentation is present to facilitate charge capture. Daily review and processing of ED facility level charges, ED procedures, injections, infusion, other administrations, and pre-bill edits.

Interacts as needed with internal customers to include but not limited to hospital staff, ED care providers and leadership, and other revenue cycle team members. Actively participates in department and hospital performance initiatives when needed to ensure overall UofL Health success.#
** Additional

Job Description:

**** Essential Functions
*** Timely review and capture of emergency department (ED) facility level charges using points tool.
* Maintain productivity standards by ensuring that ED charge capture remains current or entered within 3 days of patient discharge.
* Maintain overall financial viability for UMC Revenue Cycle through collaboration and effective communication with ED care providers and leaders as well as coding, billing, and other charge entry staff.
* Collaborate with care providers to resolve missing documentation needed to accurately capture ED charges.
* Perform other duties as assigned or required.
** Additional Duties of ED Revenue Integrity Specialist II:
*** Assign the appropriate ED facility E/M level, procedure, injection/infusion and administration charges for hospital services in accordance with CMS Official Coding Guidelines for Coding and Reporting.
* Assign appropriate modifiers with ICD-10-CM, CPT and HCPCS Level II codes.
* Research and resolve billing and coding issues for ED pre-bill edits to ensure timely filing of clean claims and overall reduction of discharge, not final bill (DNFB) status.
* Maintain productivity standards by working to resolve outstanding ED-related pre-bill edits timely.
* Assists with education of clinical service line regarding coding and billing.
* Attend required continuing education workshops, webinars, etc., for coding/billing compliance.
* Gather and report trends and/or findings regarding billing errors to appropriate revenue cycle leadership.
** University of Louisville Hospital Core Expectations
**** Collaboration & Teamwork:
** works cooperatively and collaboratively with others toward the accomplishment of shared goals**.
Valuing Diversity:
** recognizing and embracing the unique talents and contributions of others.

** Service Orientation:
** desire to serve and focus one’s efforts on discovering and meeting the needs of internal and external customers.

** Achieves Results:
** reflects a drive to achieve and outperform. Continuously looking for improvements. Accepts responsibility for actions and results.

** Organizational Alignment:
** ability to align people, processes and organizational structure with UMC’s strategic direction.

** Developing Others:
** views people, their knowledge and capabilities as assets and provides opportunities that allow employees to continuously learn and develop.

** Communication:
** practices attentive and active listening and can restate opinions of others; communicates messages in a way that has the desired effect.

** Integrity:
** conducts business with honesty and professional ethics. Seeks to achieve results in the best interest of the organization. Models and reinforces ethical behavior in self and others.
** Additional Responsibilities:
*** Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
* Adheres to and exhibits our core values:
** Integrity:
** Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
** Excellence:
** Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
* Maintains confidentiality and protects sensitive data at all times.
* Adheres to organizational and department specific safety standards and guidelines.
* Works collaboratively and supports efforts of team members.
* Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.
** Skills, Knowledge or Abilities
** critical to this role:
* Knowledge of medical terminology, anatomy and physiology.
* Ability to foresee projects from start to finish as well as identify trends in charge reconciliation data.
* Demonstrate working knowledge of Electronic Medical Record (EMR) and Billing systems. Cerner (EMR) and McKesson STAR (Billing) preferred.
** Language Ability:
*** Must be able to communicate effectively in both verbal and written formats.
** Reasoning…