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BILLING QA COMPLIANCE SPEC

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Administrative/Clerical
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051978 Requisition #
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Under the general direction of the Supervisor Patient Financial Services this employee is responsible for the review of Inpatient and Outpatient accounts for billing and coding compliance for Patient Financial Services (PFS).  He/she  monitors for quality and appropriateness of billing, and reviews accounts for appropriate documentation to validate billing information.  This employee is also responsible for follow up on outstanding assigned accounts in their billing and follow up work queues.  All work is carried out in accordance with PFS approved policies and procedures.  The specialist is also responsible for understanding reimbursement aspects of the revenue cycle and will work to ensure Premier Health receives the appropriate reimbursement for charges billed.  The auditor is responsible for understanding governmental rules and regulations regarding chargeable verses payable, and the components of a compliance claim.


Education


Minimum Level of Education Required: Associate degree


Additional requirements:

Type of degree: Associate degree in Healthcare, Business Administration, Health Information Management or LPN in lieu of an Associate degree is required.


Licensure/Certification/Registration

  • RHIT, RHIA, or CCS preferred


Experience

 

Minimum Level of Experience Required: 1 - 3  years of job-related experience



Prior job title or occupational experience: Revenue Cycle Experience.

Prior specific functional responsibilities: Demonstrated working knowledge of Microsoft Office applications is required. Demonstrated ability to train and educate to all levels of the organization is required.


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