Iasis Healthcare Revenue Integrity Analyst in Houston, Texas
Responsible to handle the accounts which are the responsibility of Revenue Integrity Analyst on the daily Failed Claims, Failed Bill, Unbilled Issues, Rebill, Pre-Admit and HIM logs and reports.
Handles "Special Handling" contractual accounts: such as; Marine Healthcare Services, Life Gift, 72 hour compliance, etc.
Responsible for handling of daily late charges/report, modifier report.
Responsible for monitoring accounts in regards to the ABN processes and monthly review.
Assists Customer Service Representatives when questions arise from customers charges on account.
Performs research regarding charge issues and provides various depts. Works with Revenue Integrity Audit Nurses to resolve outstanding issues.
Works closely with HIM, Admitting and Registration departments, as well as various departmental personnel from the Central Business Office regarding various issues/resolutions.
Participates in various conference calls regarding billing compliance and charging issues.
Responsible for working all reports to ensure accounts are charged appropriate in regards to non-covered items for Medicare patients. Monitors ABN and LMRP process to ensure write off volume is appropriate for facility and that admitting and registration is compliant with the compliance.
Processes applicable transactions to patient accounts: charging, discounts and various adjustments to patient accounts.
Performs system build and maintenance in HSM and STAR CDM for charges and procedures.
Monitor daily Charge Reconciliation compliance for all ancillary departments.
Stay abreast of governmental hospital related billing regulations. To include the review and determination of applicability of regulations that may impact SJMC
Requires previous hospital experience, and prefer minimum 5 years experience in Hospital Business Office setting especially the billing department.
Familiarity of hospital Charge master and hcpcs, cpt, modifiers and revenue codes.
Knowledge of excel spreadsheet and word processing required.
Job reference #: 1605148