CLIN. REIMBURSEMENT SPEC.

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

Under the direction and supervision of the Interventional Coordinator of the Cath Lab/EP Lab, the job consists of these main areas, which are vital for financial performance, charge capture, data collection, increased reimbursement, and process improvement: 1. Charge Capture, Reimbursements for procedures, and Oversight of denials in Cardiology Department 2. Data/volume tracking for department (i.e. ACC, physician benchmarking, etc) 3. Oversight of Late charges and Chargemaster development. 4. Complications Tracking Management (Adverse Events/Peer Review) and Audit Reviews. 5. Performs all duties that directly and indirectly support the billing and data collection processes in Section of Cardiology. Provides project management expertise necessary to drive significant positive financial breakthroughs within both departments. Responsible for independent action under the directions of the Director, Cardiovascular Services in project oversight and special financial projects as assigned by Director, Cardiovascular Services.

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EEO/AA/Disability/Veteran

Responsibilities

  • 1. Charge Capture, Reimbursements/Collections for procedures, and Oversight of Denials.
    • 1.1 Reviews, edits, and interprets TSI reports for Cardiac Procedures (i.e. Angios, Pacemakers) and present to leadership in Cardiology area.
  • 2. Data monitoring and volume tracking for department to ensure financial viability.
    • 2.1 Maintain monthly databases for Cath lab/EP lab for volume data and physician profiling and share with management in Section of Cardiology on a weekly/monthly basis.
  • 3. Oversight of Late charges and Chargemaster development.
    • 3.1 Update charge master as needed (SDK, Charge Master).
  • 4. Complications Tracking Management (Adverse Events/Peer Review) and oversight of Audit/Financial reviews.
    • 4.1 Oversight of Complications in department and Adverse Events in Cath Lab/EP lab.

Qualifications

EDUCATION

 

Bachelor's degree in Business Administration, Nursing, or other related fields or equivalent operations supervisory experience.

 

EXPERIENCE

 

5-10 years healthcare experience (clinical background is preferred).  CATH LAB EXPERIENCE, RN, RT, BACKGROUND STRONGLY PREFERRED. CODING CERTIFICATION STRONGLY PREFERRED.

 

SPECIAL SKILLS

 

Computer literate, knowledge of Excel, able to prepare accurate, thorough reports for administration. Able to communicate and interact with multiple departments. Excellent Organizational and Presentation skills.

 


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