This position will allow remote work in one of the following approved states:
Arizona, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, Utah, or Wisconsin
Typical pay range: $22. 75- $30. 40

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: Observation Revenue Charge Specialist

REPORTS TO POSITION: System Revenue Integrity Manager

DEPARTMENT: Revenue Integrity

DATE LAST REVIEWED: 09/14/2018

OUR VISION: Creating America's healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver a delightful, transparent and seamless experience to our patients and customers that captures and collects the revenue earned by SCHS in a quality, efficient and timely manner.

POSITION OVERVIEW: The Observation Revenue Capture Specialist at St. Charles Health System is responsible for calculating appropriate observation charges which include infusion and injection charges as applicable. This position does not directly manage other caregivers, however may be asked to review and provide feedback on the work of other caregivers.

ESSENTIAL FUNCTIONS AND DUTIES:

Read and interpret documents contained within the medical record to calculate accurate observation charges.

Carve out monitored services from overall observation time using CMS guidelines and St. Charles Healthcare System policy and procedures.

Apply CPT codes for infusions and injections following CPT coding guidelines, Medicare/Medicaid/Payor guidelines, Federal and State regulations and or laws.

Provide education back to nursing departments on missing or incomplete documentation.

Work closely with Utilization Review to determine appropriate patient type.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all company investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate.

Supports the vision, mission and values of the organization in all respects.

Supports Value Improvement Practice (VIP- Lean) principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate.

May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION

Required: High School Diploma required.

Preferred: Graduate of an AHIMA Accredited Health Information Technology program or certification in a self-study course from AHIMA or AAPC preferred.

LICENSURE/CERTIFICATION/REGISTRATION

Required:

Preferred: Registered Health Information Technician (RHIT) certification or one or more of the following: RHIA, CCA, CCS, CCS-P, CPC, CPC-H preferred.

EXPERIENCE

Required:

Preferred: Two years of coding experience with a Health Information Management focus preferred, two years experience in charge capture preferred.

PERSONAL PROTECTIVE EQUIPMENT

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Skills

Basic to intermediate ability and experience in computer applications, specifically electronic medical records system and MS Office

Knowledge of CMS guidelines related to Observation charging.

Knowledge of CPT-4 code assignment

Knowledge of CCI and MN edits and APC grouping.

Knowledge of modifier and revenue code assignment.

Maintains professional knowledge by attending educational workshops, reviewing professional publications, participating in educational opportunities.

Communication/Interpersonal

Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS.

Ability to effectively interact and communicate with all levels within SCHS and external customers/clients/potential employees

Strong team working and collaborative skills

Must be able to efficiently handle telephone calls and meeting & resource coordination.

Must have a positive attitude, ability to multi-task, pay close attention to details, and be able to act in a professional manner and demonstrate excellent public relations skills.

Ability to work in a fast paced work environment with frequent interruptions, maintaining the highest level of confidentiality at all times.

Organizational

Ability to multi-task and work independently

Attention to detail

Excellent organizational skills, written and oral communication and customer service skills, particularly in dealing with stressful personal interactions

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.

Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.

Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors

Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category

No Risk for Exposure to BBP

For HR Use Only:

FLSA Status: Non-exempt

Wage Grade: 112

Pay Rule: For Exempt use BWEF

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