Revenue Cycle Analyst

Wayne HealthCare - Greenville, OH

Department: Financial Services 
Status: Full Time
Shift: First Shift

This full time, first shift position is responsible for the coordination of efforts to ensure timely and accurate processing of charges for processing of claims in a manner that is consistent with industry best practices. This position must be able to effectively communicate with Director of Senior Behavior Health, Director of Health Information Management, and Director of Patient Accounts. This position is a direct report to Controller. This is an onsite position.

Qualifications:

  • Minimum of 2 or more years’ experience in facility coding, facility billing and/or physician healthcare claims within a health care system.
  • Associate or other degree.
  • Certified professional coder or equivalent training
  • Must be knowledgeable regarding payor billing guidelines and hospital and physician claim form billing requirements.

Responsibilities:

  • Through direct efforts and coordination, ensure timely and accurate processing of charges for processing of claims in a manner that is consistent with industry best practices.
  • Daily reconciliation of billing and reimbursements as it relates to Senior Behavior Health Unit.
  • Ensure compliance with industry standards, regulations, and company policy and procedure.
  • Charge capture from providers received daily and reconcile superbills/lost tickets each day from SBH unit
  • Responsible for making sure all claims have the appropriate documentation before being coded and claims submitted.
  • Assists department with research of claims not paid and other duties assigned.
  • Audit medical notes and superbills for accuracy in CPT, HCPCS, ICD-10 coding
  • Documents all communications and activities in billing and financial notes in Thrive to assist with clear, concise and accurate communication to all who work with patients billing ledgers and processes.
  • Coding - Reviews all documentation to ensure coding by provider is supported
  • Apply all coding rules and use of CPT and ICD codes and appropriate use of modifiers.
  • Where providers have made errors or missed coding, use as educational tool for the provider(s).
  • Assist in educating physicians and staff in requirements of documentation for proper reimbursement.
  • Assists all staff with coding as required.
  • Constant review and recommends updates on coding changes.
  • Assists with annual superbill review and update with CPT and ICD-10 codes.
  • Assists in conducting internal audits of patient charges and corresponding documentation.
  • Pre-authorizes all SBH stays.

Wayne HealthCare is a tobacco free environment and as such no longer hires tobacco users.

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