Facility Revenue Compliance Liaison Finance FT
Portsmouth, NH, United States
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SHIFT: No Weekends
Portsmouth Regional is a 209-bed acute care hospital located in Portsmouth, NH, and is part of HCA, the nation’s largest provider of healthcare services. Portsmouth Regional Hospital serves the seacoast region’s residents in New Hampshire, Maine and Massachusetts and is one of the area’s largest employers. Portsmouth Regional Hospital is the only Level II Trauma Center on the Seacoast and one of only three in New Hampshire to earn this important distinction.
Facility Revenue and Compliance Liaison
- Analyze and resolve specific billing edits that require clinical expertise that are delaying claims from processing. This includes the verification and/or correction of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation. This also includes the application of modifiers and condition codes, as appropriate.
- Identify charging, coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues.
- Perform detailed audits of patient accounts to determine charging accuracy and HIM assigned codes. By analyzing audit findings, recommendations are made to facility ancillary department directors in order to improve documentation, charging flow, and accuracy.
- Submit rebills, l-lines, p-lines, etc as outlined by Corporate policy to (Shared Services) Revenue Integrity.
- Perform specific audits in outpatient clinics related to high risk items. Provides education to outpatient clinics.
- Maintain knowledge of hospital protocols, Medicare requirements, revenue codes, ICD-9/CPT/HCCPS.
- Review HCA Regs Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Revenue Integrity procedures and implement changes as needed.
- Participate as a member of the facility FECC Committee and report charging issues as appropriate.
- Is classified as a coder and takes all courses as required by HCA policy.
- Other duties as assigned.
Required - Hospital-based training, ICD-9 CM coding and CPT coding.
Healthcare experience required.
Clinical experience preferred.
Required - High school graduate or equivalent; ICD-9 CM coding course; Certified Professional Coder (CPC-H or CPC-P)