Northwell Health Spclst Outpatient Revenue in Westbury, New York
Req Number 0011M3
Job Category Finance
As the Outpatient Revenue Specialist, you will function as a liaison between the physicians' and ancillary departments regarding the instruction of regulatory guidelines. In this role, you will serve as an on-site resource for CPT-4 and ICD-9-CM coding, and charging issues. You will be responsible for in servicing clinical staff of changes (additions/deletions) that take place in the CDM.
Responsibilities include :
- Liaison between physicians and ancillary departments regarding the
instruction of regulatory guidelines.
Encourages communication between departments to resolve coding and billing issues.
Meets with hospital personnel, as needed, to review that regulatory changes are adhered to.
Maintains a reasonable understanding of the billing process to ensure that hospital procedures and services are properly ordered.
Is familiar with APC coding and identifies front-end process improvement initiatives.
Monitors coding changes for governmental agencies and other payers; educates departments on coding and compliance issues.
- Responsible for CDM Validation.
Validates CDM Maintenance Forms prepared by Financial Analysts in a timely manner.
Ensures HCPCS codes and revenue codes are in compliance with the Federal Register and other regulatory agencies.
Uses all coding resources, including researching availability of additional documentation to assign accurate HCPCS codes.
- Conducts CDM Educational Sessions.
Conducts educational sessions with clinical staff members regarding the contents of the Charge Description Master (CDM). .
Ensures that department heads are trained in the proper CDM maintenance procedures.
Keeps abreast of federal regulatory agencies and changes in coding and reimbursement.
Bachelor's Degree in Health Information Management, Business
or related field, required.
Credentials in one or both of the following, required:
Certified Coding Specialist (CCS)
Certified Professional Coder (CPC)
Minimum of one (1) year coding program experience in acute care facility.
Thorough knowledge of ICD-9-CM, CPT-4, HCPCS and DRG coding and classification systems.