Job Description

· Performs weekly audits of the chargemaster to ensure charge accuracy and compliance with all pricing.

· Performs routine audits of each hospital department’s Posted Charges reports in order to maximize charge capture.

· Facilitates development of strategies to improve reimbursement after identifying trends that negatively impact revenue capture.

· Performs routine audits of each hospital department’s Posted Charges reports in order to maximize charge capture and ensure correct reporting of medical services.

· Performs weekly audits of the chargemaster to ensure charge accuracy and compliance with all pricing.

· Liaises with the Analyst – Clinical Billing Compliance and Systems & Contracts Specialist to implement changes in the chargemaster and/or Contract Management that were identified during routine audits.

· Analyzes coding and charging by Outpatient departments following billing guidelines for high riyal departments, i.e.; Emergency Room, Specialty Clinics, procedures performed within the clinics.

· Actively seeks opportunities to positively impact Revenue Integrity workflows and metrics, utilizing experience to identify process improvement needs and to design and implement best practices.

· Works with other departments, physician offices and the Training Specialist to adapt best practices to changing needs within the healthcare environment. Escalates issues to Manager when a department is not responsive to suggestions for preventing revenue loss.