Coordinator, Revenue Integrity (Full-Time, 40 Hours, Day Shift)

The Queen's Health Systems; Honolulu (HI); On-site; USD 70,000 - 95,000; Full time

Job summary

The Queen’s Health Systems is seeking a Revenue Cycle Auditor to ensure accurate charge capture and timely billing for hospital services in Hawaii. The role focuses on identifying compliance issues, addressing root causes, and implementing workflow improvements to prevent recurrence.

Qualified candidates will have a bachelor’s degree in a related field (master’s preferred), and at least three years’ experience across revenue cycle areas, with knowledge of CPT/HCPCS, ICD-9 coding, and

Qualifications

• Bachelor’s degree in Business Administration, Finance or Health Care Administration or four years progressive Revenue Cycle/Finance experience.
• Master’s degree in a related field preferred.
• Three years’ experience in two or more revenue cycle areas (e.g., patient access, charge capture, billing, follow-up) with lead or supervisory exposure.
• Knowledge of CPT/HCPCS, revenue code assignment, and ICD-9 coding.
• Knowledge of reimbursement regulations, Medicare/Medicaid requirements, and medical terminology.
• Proficiency in Word and Excel; experience with Epic systems and Crystal Reports.

Responsibilities

• Audit the charge capture process to ensure timely, accurate billing of all valid charges.
• Identify charge compliance issues and root causes; implement workflow changes to prevent recurrence.
• Monitor activities to protect the organization from penalties by ensuring accurate hospital billing.
• Provide education and training to departmental staff on charging procedures.

Skills

CPT/HCPCS knowledge

ICD-9 coding

Charge master understanding

Epic systems

Crystal Reports

Excel

Word

Education

Bachelor’s degree in Business Administration/Finance/Health Care Administration

Master’s degree preferred

Tools

Epic systems

Crystal Reports

Excel

Charge Master

Job description

RESPONSIBILITIES

I. JOB SUMMARY/RESPONSIBILITIES:

• Responsible for auditing the charge capture process to ensure that all valid charges are captured in the billing process in a timely manner.
• Identifies charge compliance issues and root causes of noncompliance. Ensures correction of such issues and develops changes to workflow processes to ensure that such issues are prevented in the future.
• Monitors functions and activities to safeguard The Queen’s Health Systems (QHS) against exposure to penalties and fines by ensuring healthcare services are billed accurately and properly at all times.
• Provides education and training to departmental staff to ensure understanding and compliance to correct charging procedures.

II. TYPICAL PHYSICAL DEMANDS:

• Essential: Sitting, finger dexterity, seeing, hearing, speaking, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.
• Occasional: Standing, twisting body, lifting and carrying usual weights of 15 to 30 pounds, reaching above, at, and below shoulder level.
• Operates personal computer, calculator, telephone, fax and printer.

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION/CERTIFICATION AND LICENSURE:

• Bachelor’s degree in Business Administration, Finance or Health Care Administration or related field; or four (4) years progressive experience in Revenue Cycle or Finance may be substituted for the educational requirement.
• Master’s degree in a related field preferred.

B. EXPERIENCE:

• In addition to the education requirement, three (3) years experience in two (2) or more areas of the revenue cycle process to include, but not be limited to patient access, scheduling, charge capture, CDM maintenance, claims submission and follow-up, payment posting, collections, claims adjudication, third party payer contracts, government reimbursement and policies, compliance, net revenue and/or profitability analyses, preferably in an acute care facility.
• Experience in a lead or supervisory role.
• Experience to demonstrate the following:
  • Working knowledge of CPT/HCPCS and revenue code assignment and ICD-9 coding.
  • Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting.
  • Working knowledge of health care delivery systems, including contracting and financial analysis.
  • Knowledge of reimbursement regulations, including Medicare/Medicaid program requirements, and medical terminology.
  • Ability to develop and implement education/training programs and activities.
  • Proficiency in computer applications such as Word and Excel, and computer-based hospital billing/records applications with preference given to experience with Epic systems.
  • Knowledge of Crystal Report Writer.

Equal Opportunity Employer/Disability/Vet