Charge Integrity Specialist — Revenue Optimization

300 Sharp HealthCare; San Diego (CA); In loco; USD 43.000 - 60.000; Tempo pieno

Descrizione del lavoro

Sharp HealthCare in San Diego, CA is seeking an experienced Charge Integrity Specialist to serve as the operational SME for all charge integrity solutions across the System Revenue Integrity Department. You will coordinate revenue enhancement opportunities and ensure timely charge entries, with a strong focus on accuracy and data-driven improvements.

Required qualifications include 1 year of hospital/ambulatory charging experience or related revenue cycle work and a CA driver’s license.

Competenze

• 1 Year experienced with hospital and ambulatory care charging and coding practices, or hospital revenue cycle, or contractual payment schemes.
• Driver's License - CA Department of Motor Vehicles - REQUIRED

Mansioni

• Analyzes, Evaluates, and Reports Reviews and follows-up on daily reports, system work queues and/or vendor portal to identify accounts that have potential lost, over, undocumented, duplicate charges.
• Identify, trend and report potential systemic issues to Charge Integrity Team for resolution.
• Conduct root cause analysis of charge integrity issues and provide recommendations.
• Follow up directly with department to ensure charges are entered onto accounts timely.
• Reviews and follows-up on daily reports to identify late charges.
• Researches, identifies, prioritizes, and communicates charge integrity opportunities.
• Demonstrates superb attention to detail and analytical thinking skills.
• Department Support and Teamwork Maintains expertise in accurate charge entry and coding requirements, collaborates with coding compliance specialist(s). Work collaboratively across disciplines and communicate with various customers while seeking solutions. Might be assigned to support key clinical areas on a need basis.
• Department System Competency Maintains expertise in charge source criteria and IT interfaces from upstream systems. Assists in deploying technology solutions, developing standard approaches, tools, reports, communication, policies and procedures to be utilized across the system.
• Problem Resolution
• Reviews and follows-up on issues in assigned work-queues.
• Follows-up with clinical, coding, billing and operational contacts to resolve revenue integrity concerns in a timely manner.
• Assigns actions, turnaround times to appropriate parties, monitors progress and results, reports out to management.
• Contributes to analytical, technical and operations problem solution efforts. Works with revenue integrity, finance and clinical leadership to develop, implement charge capture entry, validation, reconciliation and correction processes; developing and implementing protocols, policies and procedures to support charge capture accuracy and timeliness.
• Demonstrate Effective Self-direction and Time Management Skills Practices strong organizational and project management skills. Manages workflows and tasks by prioritizing, planning, and executing. Embodies and complies with Sharp behavioral standards. Keeps current with trends, developments in the profession, industry and related fields of expertise.
• Knowledge, Skills, and Abilities Must have an understanding of Revenue Cycle concepts and knowledge of clinical concepts. Must be proficient with Microsoft Office Applications.

Conoscenze

Charge integrity analysis

Data interpretation

Attention to detail

Time management

Formazione

Bachelor's degree or relevant experience in excess of four years

Strumenti

Microsoft Office

Descrizione del lavoro

Sharp HealthCare in San Diego, CA is seeking an experienced Charge Integrity Specialist to serve as the operational SME for all charge integrity solutions across the System Revenue Integrity Department. You will coordinate revenue enhancement opportunities and ensure timely charge entries, with a strong focus on accuracy and data-driven improvements.

Required qualifications include 1 year of hospital/ambulatory charging experience or related revenue cycle work and a CA driver’s license.