Clinical Revenue Assurance Specialist
Advocate Aurora Health
Department:
Status:
Benefits Eligible:
Hours Per Week:
Schedule Details/Additional Information:
Monday- Friday Remote 630- 3 or 730- 4
Pay Range
$34.90 - $52.35Major Responsibilities:- Processes assigned hospital billing work queues in Smart Chart.
- Responsible for trending revenue capture and adherence to standardized charging practices. Provides clear, concise reporting to system leadership.
- Drafts, updates and distributes consistent and accurate hospital billing resources that are understood by targeted audience.
- Provides specialty-focused charge capture education which is tailored for a variety of audiences including billing office, charge entry caregivers, RN, certified therapies and clinical leadership.
- Reviews service line charge capture practices to identify opportunities for enhanced revenue while facilitating consistent charge capture across the system.
- Develops Revenue Assurance departmental charge correction procedures and policies to facilitate consistent hospital billing for the enterprise.
- Partners with IT, MMIS, Chargemaster and pharmacy to maintain and enhance the integrity of charge capture structures within the electronic medical record.
- Participates in departmental quality initiatives.
- Routinely provides summary of efforts to standardize and enhance charge capture for hospital billing across the enterprise to Revenue Assurance leadership.
- Develops, participates and coordinates a variety of enterprise-wide audits, including service line focus audits. Represents Aurora Health Care during external defense audits.
Licensure, Registration, and/or Certification Required:
- Registered Nurse license issued by the state in which the team member practices.
Education Required:
- Bachelor's Degree in Nursing.
Experience Required:
- Typically requires 3 years of experience in inpatient hospital clinical care such as nursing, respiratory therapy, radiologic technologist, physical therapy, occupational therapy.
Knowledge, Skills & Abilities Required:
- Ability to apply clinical knowledge to facilitate comprehensive revenue capture for service lines.
- Advanced knowledge of hospital billing guidelines, payer reimbursement policies and medical necessity criteria.
- Maintains expert knowledge of CPT, ICD-9, ICD-10, HCPCS coding, CCI edits and modifiers.
- Must be knowledgeable in the technical aspects and integrated functionality of clinical and revenue cycle applications.
- Ability to utilize advanced features of Excel, Outlook and other Microsoft products.
- Excellent organization, prioritization, problem solving and reading comprehension skills.
- Excellent critical thinking and analytical skills, with a high attention to detail.
- Ability to successfully lead a team and problem solve complex billing scenarios.
- Ability to mentor other staff and act as a resource on complex audits. Ability to train staff on auditing processes and procedures.
- 10. Ability to take initiative and work collaboratively with others.
Physical Requirements and Working Conditions:
- Must be able to sit 95% of each day.
- Must be able to routinely lift up to 10 lbs. when carrying medical records to place of work.
- May be exposed to extreme weather conditions when traveling between affiliates.
- Operates all equipment necessary to perform the job.
- Exposed to normal office environment, including long period of time viewing computer screens.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.