Covenant Health

Revenue Process Coordinator, Corporate Rev Process

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.

Position Summary:

Coordinates and performs the charge process for all procedures performed in Cardiac Cath labs (including employed Cardiologists involved in Cath procedures) and Interventional Radiology departments within Covenant Health’s acute care facilities.  Work involves leading charge process by analyzing physician and nursing documentation, determining appropriate charges, identifying and addressing documentation issues, resolving issues identified by the business office due to claim edits or modifier needs, identifying and reporting issues that will impact revenue and/or productivity through communication with the appropriate leadership of respective facilities.  Maintains all organizational and professional ethical standards and works with Covenant leaders to coach, mentor, and train department staff.  Works independently under limited supervision with significant latitude for initiative and independent judgment.  Reports to the Sr. Revenue Process Coord – CV/IR.

apply@covhlth.com

• Reviews physician dictation and procedure documentation to determine appropriate charges supported for procedures performed in the cardiac cath lab by using clinical expertise of procedures performed and applying regulatory guidelines for coding, charging and billing.
• Reviews physician dictation and procedure documentation to determine appropriate charges supported for procedures performed in interventional radiology departments by using clinical expertise of procedures performed and applying regulatory guidelines for coding, charging and billing.
• Reviews physician dictation and procedure documentation to determine appropriate physician charges for employed Cardiologists supported by procedures performed in the cardiac cath lab by using clinical expertise of procedures performed and applying regulatory guidelines for coding, charging and billing.
• Facilitates and maintains communications with respective facility leaders and/or physician office contacts when areas of opportunity are identified with physician or clinical documentation which result in delays with the charge process, impact to compliant optimal department revenue, risk from a lack of documentation or any other issue impacting operations of their department as a result of the charge process.
• Performs assigned charge processes centralized by the department but unrelated to Cath and IR (i.e. Intercompany charges, missing implant/device follow-up, explanted device, etc.)
• Reviews and reconciles charge reports, bill hold data and account tracking for accuracy of the charge process. Performs this daily with precision and addresses any discrepancies in a timely manner to allow correction prior to claim processing. 
• Performs research and analysis of charges, CPT coding, modifiers and billing processes to ensure compliance with Medicare, Medicaid, and other State and Federal governmental agency’s procedural and regulatory guidelines pertaining to charge processes centralized under this team.
• Performs routine departmental monitoring to maintain an acceptable level of compliance relating to the charging, coding, and billing of Cath Lab and Interventional Radiology services.  
• Assists the Revenue Integrity Department on appeals relating to denials for Cath Lab and Interventional Radiology departments and assists the Compliance office with investigations, research, solutions or corrections to maintain proper compliance in coding, billing and reimbursement.
• As the charge expert for Cath & IR procedures, works collectively within the CV team to function as a liaison to department and facility leaders, employed physician offices, HIM, patient accounting, billing, IT and other personnel with solutions needed to support their processes (i.e. billing rules, CPT guidance, compliance, and reimbursement). Uses this opportunity to provide education, customer service, identify process improvement initiatives and enhance quality. Through this coordination, promotes a positive experience and good public relations for the Corporate Revenue Process department.
• Effectively uses and monitors the compliance of electronic tools used to determine the appropriate charges. Utilizes resources available appropriately, i.e. use of Covenant Health equipment and/or supplies.
• Recognizes situations which necessitate supervision and guidance, seeking and obtaining appropriate resources.
• Maintains professional growth and development through continuing education, seminars, and applicable professional affiliations to keep informed of industry trends.
• Works as a team with co-workers to identify process improvement activities, audit opportunities, goals and projects.
• Displays a willingness to generate a positive, harmonious relationship with all co-workers. Seeks opportunities to positively impact overall department culture through participation, volunteering to informally lead, invests positively in team's attitude and perspective by demonstrating pleasant behavior, encouraging spirit and team commitment.
• Assists with special projects.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:           

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:         

Three (3) to five (5) years’ experience required in a healthcare specific field.  Good working knowledge of healthcare billing, Medicare/Medicaid billing guidelines and other Third Party Payor rules and regulations, Experience in problem solving, analytical reviews, must be knowledgeable in use of PC’s, Windows, Excel and Word Processing; must have good public relations skills.

Licensure Requirement:      

Must have and maintain license in the State of Tennessee or Certification in an appropriate field of study (e.g. RN, RCIS, RTR, RHIT, CCS, CPC etc.).   CIRCC is preferred.