Northwell Health Spclst Outpatient Revenue in Westbury, New York

Req Number 0011M3

Job Category Finance

Job Description

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 :

  1. 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.

  1. 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.

  1. 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.

Qualifications

  • 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.