Outpatient Specialist

• Schedule - Shift - Hours Part Time - Day Shift - 24 hours

Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.
As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 10,000 who are shaping the future we envision.
Moffitt has been recognized as a Best and Brightest Company to Work for in the Nation, a Digital Health Most Wired Organization and continually named one of the Tampa Bay Time’s Top Workplaces.
A National Cancer Institute (NCI)-designated Comprehensive Cancer Center since 2001.

Summary

The Outpatient Charging Specialist ensures a consistent and timely charge capture in a clinical system to promote accurate outpatient charging supported by clinical documentation. Coordinates efforts with the Clinical Departments and Revenue Cycle areas to ensure compliance with Moffitt's charging policies and Regulatory guidelines.

Responsibilities:

• Validate and determine appropriate coding as needed by obtaining and reviewing clinical documentation in various applications to ensure that it supports the services provided to the patients
• Enters the charges for outpatient cases in the clinical system utilizing a charge ticket or any other established charge entry methodology
• Follows the charging and coding guidelines to ensure compliance with CMS regulations.
• Works with various clinical team members to ensure charges are captured correctly and timely.
• Interacts with all clinical team members providing training and feedback on charging opportunities.
• Works with Revenue Integrity to ensure the charge tickets are up to date to maximizing the charges captured.
• Serves as resource for charging, clinical documentation and reimbursement issues.
• Participate in education programs to maintain up-to-date coding skills.
• Charge Auditing
  • Assists in the evaluation, research and analysis of charging, revenue, and billing to ensure compliance with all payer requirements and determine patterns of charging that will avoid compliance risks and/or increase the propensity for payment of charged services.
  • Works with Nursing Leadership to optimize reimbursement, ensure charge capture and provide feedback on revenue opportunities, documentation, and payor standards.
• Special Projects
  • Provides assistance on special projects as assigned.
  • Participates on training and educational initiatives regarding clinical documentation to support charge optimization.
• Other Duties As Assigned

Minimum Education:
High School Diploma/GED

Minimum Experience

Required:

• Minimum of four (4) years experience in related healthcare field is required.
• Related experience may include a combination of clinical (nursing or allied health), coding, provider billing, medical records, charge audit environment, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting.
• Inclusive of one (1) year of experience in healthcare provider setting; preferably in infusion, radiology, surgery, pharmacy or laboratory
• Understands financial management and health care reporting, including the relationship between the Charge Description Master (CDM), charging and cost reporting
• Possesses a working knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), and Healthcare Common Procedure Coding System (HCPCS) and Current Procedural
• Possesses a working knowledge of hospital and professional claims forms
• Understands charging processes and compliance issues and has the ability to provide resolutions by performing internet research, utilizing third party payor regulations, referencing coding guidelines, and referencing local Fiscal Intermediary and Center of Medicare and Medicare guidelines
• Demonstrates knowledge and proficiency of standard PC word processing, spreadsheet, database and presentation applications (e.g., Word, Excel, Access, PowerPoint) to develop, prepare and analyze statistical reports
• Excellent project management, problem solving and analytical skills
• Ability to work independently, identify and resolve problems
• Excellent…