Senior Certified Revenue Cycle Analyst
The HIM/CBO team lead will be responsible to maintain DNFB and Unbilled claims for outpatient, day surgery, wound, laboratory, and radiology services. He/she will be responsible to work with the hospital departments to clear edits and reduce denials.
- Creates daily assignments for the CBO HIM team in N Thrive
- Runs HCPCS conflicting Reports for assignments and resolutions
- Performs clean claim analysis
- Monitors Xclaim Aging report and keeps current
- Is a conduit for Coding Manager with the facilities for non-coding related claims which need HIM intervention
- Creates meaningful education content from clean claim analysis outcomes
- Maintains schedules and resource availability for the CBO Works with HIM/Centralized Business Office processing Unbilled XClaim edits.
- Reviews encounters for 72 hour combine for coding/billing compliance
- Works with the CBO to create edits to ensure prompted payments.
- Works with CBO to remove edits by payer to improve the clean claim rate.
- Provides CBO and Hospitals feedback of areas of opportunity if necessary
- Assists coding manager as needed with coding claim resolutions
- Communicates and escalates relevant issues to billing as needed
- Prepares key performance reports for HIM/Coding Leadership
- Complies with facility policies and regulations.
REQUIRED KNOWLEDGE & SKILLS:
- Minimum coding certification of CPC, CCS, COC or RHIT
- Working knowledge of Microsoft PC applications (Outlook, Word, Excel)
- Ability to foster a cooperative work environment
- Strong interpersonal/public relations skills and the ability to work effectively with a wide range of customers in a diverse environment
- Ability to establish priorities effectively
- Experience with Meditech and XClaim preferred
- Education: Associates Degree Required, Bachelor’s Degree Preferred
- Experience: Prior work experience in outpatient coding edit resolution with knowledge of CCI, OCE, NCCI and LMRP
- Certification/Licensure: AHIMA or AAPC coding credential