POSITION SUMMARY

• Responsible for patient account accuracy through audits of charging, billing and documentation compliance with third party payor requirements, governmental regulatory agencies and SIH policies and procedures.

EDUCATION

• Associate’s degree in Nursing

EXPERIENCE AND SKILLS

• Technical Experience: 3 years

COMPENSATION (COMMENSURATE WITH EXPERIENCE):

$63,585.60 - $98,550.40
To access our Benefits Guide/Plan Information, please click the link below:
http://www.sih.net/careers/benefit

PRINCIPAL ACCOUNTABILITIES

• Standards of Performance: Respect, Integrity, Compassion, Collaboration, Stewardship, Accountability, Quality

ROLE SPECIFIC RESPONSIBILITIES

o Performs audits comparing the medical record to the patient’s account to determine charging and billing accuracy.
o Utilizes the Nurse Audit Program for the addition, reversal, or adjustment of charges based on medical record documentation.
o Upon request of Compliance Officer, monitors use of the appropriate CPT/HCPCS codes for certain items or services with known or suspected coding, charging, documentation and/or billing concerns or specific payor requirements.
o Identifies issues related to inappropriate charging and conducts and/or participates in department or multidisciplinary training or meetings to resolve those and any other charging issues. Develops corrective action plan.
o Communicates any charge and/or billing error trends noted to the Compliance Officer, co-workers, and affected departments.
o Collaborates with the Compliance Analyst, third party auditor and others as needed in the scheduling, performance and resolution of third party audits.
o Performs or assists in Compliance audits, investigations or other special projects at the direction of the Compliance Officer.
o Perform necessary adjustments to patient accounts to meet clinical trial billing requirements.
o Collaborate with nursing, patient intake, health information, case management, and patient financial services to improve patient account documentation and assignment of the appropriate patient type and status.