Charge Integrity Support Specialist - Revenue Integrity - Corporate Office - Day Shift - Full Time

300 Sharp HealthCare; San Diego (CA); On-site; USD 43,000 - 60,000; Full time

Job summary

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.

Qualifications

• 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

Responsibilities

• 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.

Skills

Charge integrity analysis

Data interpretation

Attention to detail

Time management

Education

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

Tools

Microsoft Office

Job description

Hours: Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $31.350 - $39.180 - $43.890 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

• To be the operational subject matter expert on all charge integrity solutions, coordinate revenue enhancement opportunities for all entities supported by the System Revenue Integrity Department and in alignment with the overall mission of Sharp HealthCare.

Required Qualifications

• 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

Preferred Qualifications

• 3 Years Experience in a large hospital setting, medical group, or consulting company.
• Certified Professional Coder (CPC) - AAPC - PREFERRED

Other Qualification Requirements

• Bachelor's degree or relevant experience in excess of four years may be substituted for degree. - Preferred
• Utilizes reliable transportation and possesses adequate personal insurance coverage. Demonstrates clean driving record in accordance with requirements of the employer DMV pull notice program and Sharp HealthCare Driver Guidelines.

Essential Functions

• 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.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class Sharp HealthCare is a not-for-profit health care system based in San Diego, California, with four acute care hospitals, three specialty hospitals, three medical groups and a health plan. We provide medical services in virtually all fields of medicine, including primary care, heart care, cancer, orthopedics, women’s health, rehabilitation, robotic surgery and bariatric surgery. Sharp sets the community standard for exceptional care. Sharp Grossmont Hospital and Sharp Memorial Hospital have received prestigious Magnet recognition by the American Nurses Credentialing Center for excellence in nursing practices and quality patient care. At the heart of our organization are more than 18,000 affiliated physicians, nurses, staff and volunteers who are on a journey to make health care better for our patients and their families. It’s what we call The Sharp Experience – treating each person with dignity, compassion and respect, and using our clinical excellence and advanced technology to deliver the highest-quality patient care. We are dedicated to transforming the health care experience by making Sharp the best place to work, the best place to practice medicine and the best place to receive care in San Diego.