Departmental Charge Specialist

Location:

Main Hospital Bldg - 3rd Floor

Responsible for researching charge discrepancies and working with other departments/ organizations to make necessary corrections.

• High School Diploma

• Must have three years experience in a hospital or business office setting to include experience in the areas of medical billing, registration, or coding.

• None

• None

• Must have knowledge of third party payors and understand managed care and insurance coverage, eligibility and explanation of benefits.
• Must have working knowledge of CPT and ICD-9 coding.
• Must be able to demonstrate a working knowledge of personal computers, to include word processing, spreadsheet, and database software.
• Must be detail oriented, possess basic mathematical skills, and have sharp analytical skills to resolve complex financial issues.
• Must demonstrate a positive demeanor, good leadership skills, good verbal and written communication skills, and be professional in both appearance and approach.
• Must demonstrate teamwork and interpersonal skills.

• Researches and monitors areas of compliance, workflow, business processes and recommends policies, procedures and other changes to improve consistency and effectiveness.
• Assists in the management/reconciliation of patient accounts with charge discrepancies by researching issues and working with Patient Financial Services (PFS) to make account adjustments in a timely manner. Ensures complete and accurate information is provided for coding and billing to ensure revenue is maximized.
• Monitors and tracks staff quality and productivity by auditing accounts to ensure adherence to policies and procedures. Participates in ongoing quality monitoring, policy review and process improvement activities.
• Serves as a lead resource for scheduling within outpatient Physical Medicine & Rehabilitation (PM&R) to achieve effective and efficient operations.
• Works with PM&R management to coordinate workflow activities. Identifies ways to improve workflow and customer satisfaction and makes recommendations to management to improve upon these areas.
• Supports and provides expertise of outpatient PM&R to achieve desired practices and/or improvement. Serves as a primary resource and liaison to administrative management staff.
• Provides daily staff support for all functional areas in outpatient PM&R.
• Assists with the selection, orientation, training, counseling and evaluation of assigned employees to ensure maximum utilization of individual and group capabilities.
• Assists with patient complaints related to scheduling, guiding the situation toward resolution or directing/escalating to the proper resource for resolution.

• Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
• Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.