Under the general supervision of the Executive Director of Emergency Services and Disaster Management and the direct supervision of the ED Business Systems Manager and within established Catholic Medical Center department policies and procedures, the incumbent performs the following functions:
Review and update ED PulseCheck charge master with CDM updates provided or requested from HIS. Completes adequate and required ED PulseCheck training to maintain proficiency in daily application support. Collaborates with and assists the ED Business Systems Manager on all ED PulseCheck application updates and upgrades. Collaborates and assists other departments who are using ED PulseCheck relevant to charge capture and reimbursement. Serves as an ED PulseCheck resource for ED and physician staff relevant to charge capture/documentation issues. Reviews entire ED PulseCheck chart, including Triage, nursing and physician documentation and physician orders to interpret and assign appropriate facility level and nurse procedure and supply charges. Checks and ensures each chart is complete and signed according to specified guidelines. Maintains a consistent productivity standard of 95-100 percent daily review and charge submission of each assigned day’s total charts but no later than 72 hours after discharge date inclusive of facility level charge assignment, procedure and supply charge entry and notification of staff by ED PulseCheck email of any chart deficiencies. Logs each “incomplete” ED PulseCheck chart by deficiency, triage date and current staff notified. Reviews list of incompletes daily and reports repeated instances of missing documentation or unsigned charts to ED management. Provides as requested and maintains relevant Charge Capture statistics extracted from ED PulseCheck report/archive function or approved SMS financial data. Participates in formulation/change of Charge Capture policies/procedures. Maintains a working knowledge of applicable Federal, State, and Local laws and regulations including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behaviors. Supports and conducts one's self in a manner consistent with customer service expectations. Performs similar or related duties as assigned or directed.
• Two years college course work in a medically related discipline or equivalent work experience in order to gain knowledge of medical terminology, anatomy/physiology, familiarity with medications, abbreviations, emergency procedures, charges for procedures. Associate level degree in a medically related discipline preferred.
• 2 years experience, preferably working in an ED/Outpatient Coding/Billing setting, with working knowledge of ICD9, CPT HCPCS and reimbursement rules for Medical Necessity, claims denial, bundling issues and charge capture.
• Certification preferred in one of the following: o AHIMA – Certified Coding Associate with experience in outpatient coding or o Certified Coding Specialist with experience in outpatient coding or o AAPC – Certified Professional Coder-Hospital Outpatient or o Certified Emergency Department Coder
Catholic Medical Center - 2 years ago