Charge Capture Analyst - Revenue Integrity_QHS (Full-Time, 40 Hours, Day )

The Queen's Health Systems; Honolulu (HI); On-site; USD 70,000 - 100,000; Full time

Job summary

The Queen’s Health Systems seeks an experienced professional to oversee revenue cycle operations, monitor charge capture and reconciliation, and refine charge guidelines to optimize financial performance.

Responsibilities include ensuring regulatory compliance, presenting financial reports to executive management, and driving improvements in workflows to prevent noncompliance and enhance revenue integrity.

Qualifications

• Associate's degree in business administration, finance or health care administration; or two years of revenue cycle or finance experience; or CCS/CPC substitution may be used.
• Three years of experience in revenue cycle, preferably in revenue integrity, coding, charge capture or billing compliance in a comparable organization.
• Knowledge of charge master principles and government-funded health care program requirements; proficiency with Microsoft Office (Word/Excel); experience with hospital billing/records applications.

Responsibilities

• Monitors charge capture and charge reconciliation outcomes.
• Reviews, develops, implements, evaluates, and revises charge guidelines to optimize revenue management; implements recommendations and monitors results.

Skills

Revenue cycle experience

Education

Associate's degree in business/finance/health care administration

CCS or CPC substituted for education

Tools

Epic systems

Job description

RESPONSIBILITIES

I. JOB SUMMARY:

• Monitors charge capture and charge reconciliation outcomes.
• Reviews, develops, implements, evaluates, and revises charge guidelines to optimize revenue management; effectively implements recommendations and monitors results.
• Identifies charge compliance issues and root causes of noncompliance. Ensures correction of issues and develops changes to workflow processes to ensure that issues are prevented in the future.
• Ensures operations and functions are in compliance with regulatory requirements and policies and procedures of QHS.
• Prepares and presents financial reports for executive management review.

II. TYPICAL PHYSICAL DEMANDS:

A. ESSENTIAL FUNCTIONS:

• Seeing. Hearing. Speaking. Finger dexterity.

B. MANUAL MATERIAL HANDLING:

• Infrequent: N/A
• Occasional: N/A
• Frequent: N/A
• Constant: N/A

C. NON-MANUAL MATERIAL HANDLING:

• Infrequent: N/A
• Occasional: Stand. Walk. Stoop/Bend. Reach: shoulder level.
• Frequent: N/A
• Constant: Sit.

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION:

• Associate's degree required, preferably in business administration, finance or health care administration; or two (2) years of experience in revenue cycle or finance; or certification as a Certified Coding Specialist (CCS) or Outpatient Physician Coder (CPC) may be substituted for the education requirement.

B. CERTIFICATION AND LICENSURE:

• Coding certification preferred.

C. EXPERIENCE:

• In addition to the education requirement, three (3) years of experience in revenue cycle, preferably in revenue integrity, coding, charge capture or billing compliance in a comparable organization.
• Experience to demonstrate the following:
  • Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting.
  • Knowledge of requirements specific to government-funded health care program and third-party payer reimbursement.
  • Proficiency with computer-based hospital billing/records applications and Microsoft Office applications, i.e. Word and Excel.
• Prior experience with Epic systems preferred.

Equal Opportunity Employer/Disability/Vet