SHIFT: No Weekends
Henrico Doctors’ Hospital is a 340-bed Level II Trauma Center offering a full range of healthcare services. We offer specialized vascular surgery, Neurosurgery, a comprehensive certified stroke center, orthopedics and groundbreaking diagnostic imaging. We're also a national trendsetter in kidney transplants through the Virginia Transplant Center and as part of the Virginia Institute of Robotic Surgery; we lead the state in minimally-invasive procedures with da Vinci robotic-assisted surgeries.
SPECIFIC ELEMENTS AND ESSENTIAL FUNCTIONS
- Responsible for oversight for facility compliance of REGS.GEN.002 (Medicare – National & Local Coverage Determination)
**Notification/distribution/education of NCD/LCD that apply to the hospital’s services, procedures and devices.
**Establish responsibility/accountability of compliance with the NCDs/LCDs
**Aid in establishing processes/procedures to perform medical necessity review prior to performing a service, procedure, or device & HINN/ABN are given before services are rendered.
**Utilize trended data to identify root cause & develop education &/or assist in developing process improvement in workflow to minimize write-offs
**Review MSC write-off report on a monthly basis to identify education/billing opportunities for Pt Access, departmental services, Coding, & validation of NCD/LCD edit application.
- Attend designated department meetings related to write-offs and process improvement
- Work in conjunction with various departments to establish pricing for CFO approval.
- Participate in all “new business” ventures to determine compliance related to Provider Based requirements, charge structure, reimbursement
**Perform post implementation audits to validate charge capture & documentation meet agreed upon criteria and follow reimbursement.
- Manage the Labor and Delivery charge capture process
- Assist with the Observation charge capture process
- Participate in unbilled management
**Weekly analysis of accounts on HOLD
**Serve as liaison between RPAS/HSC staff and facility related to charge capture/documentation issues
- Special projects as assigned by CFO/VP of Finance
REQUIRED SKILLS include:
- Clinical background or understanding of clinical operations
- Strong communication skills with hospital and medical staffs
- Understanding of services, procedures and devices provided by the hospital
- Ability to understand implications of NCDs and LCDs to hospital and hospital departments
- Capability to summarize requirements of NCDs/LCDs for education of relevant hospital departments and staff.
- Ability to use tools and resources pertaining to NCDs/LCDs which are available on Regs website, CMS’ website, Medicare Contractor’s website, etc.
- Ability to develop and deliver hospital specific educational materials
- Ability to manage multiple tasks and projects in a fast paced environment.
- Strong communications skills
- Professional in appearance and manner
- Strong organizational skills
- Ability to work well independently and as a group
5 years charging/auditing experience in an acute care hospital.
5 years of nursing or clinical experience in an acute care hospital setting.
Nurse (RN/LPN), Allied Health Professional or coding certification with coding &/or charging experience