Charge Capture Auditor

Here, it's different. Come join us.

Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years.

Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day.

We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report.

As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties.

Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat.

That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors.

A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

The Revenue Integrity (RI) Charge Capture Auditor promotes the accuracy of charging practices across the organization. This position serves as a liaison between clinical areas and revenue cycle teams to translate billing needs in order to assist clinical leadership in improving charge capture for their service lines

Department Name: Revenue Integrity
Job Status: Part-time, 40 hours per week
Shift: Day

• Education: Bachelor's degree in related field.
• Experience: Minimum 3 years of experience in health care.
• Equivalency: Minimum of 4 years of revenue integrity or related experience in lieu of Bachelor's degree.

POPULATION SPECIFIC CARE

No direct patient care.

ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

1.Identifies and performs root-cause analysis for charging issues including National Correct Coding Initiative (NCCI) edits, modifiers, Current Procedural Terminology (CPT) and Revenue Code assignment. Develops, implements, and maintains policies and procedures following Centers for Medicare & Medicaid Service (CMS) and American Medical Association (AMA) guidelines to ensure proper charge capture of billable services.
2.Serve as a liaison between clinical departments and revenue cycle departments and as a hospital resource for compliant charging practices. Is a resource for clinical team members and leaders on charging workflows and charge code questions. Assists in evaluation of new clinical services for proper charging and reimbursement considerations.
3.Partners with Clinical Application Services (CAS) teams to ensure technical implementations and system changes maintain charging compliance and optimize revenue opportunities.
4.Performs ongoing clinical service line reviews of medical records and associated billing to identify potential charging inaccuracies. Develop action plans for corrections, quantifies revenue impact, and partners with clinical areas until resolution.
5.Researches, analyzes and supports charge issues raised by third party payers and / or audit companies in coordination with other resources.
6.Partners with departments to implement charge capture improvements including changes to systems, operational procedures, or charging education to mitigate revenue leakage. Analyzes and identifies deficiencies and inaccuracies in recording charges for services rendered. Designs recommendations for improvements to improve financial outcomes.
7.Conducts chart audits to verify compliant charging in accordance with policies and regulations. Compiles findings and assesses revenue impact for charging opportunities.
8.Familiar with reimbursement trends.

SCOPE & LEVEL

Guidelines: Developmental, standard, or intermediate level. Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.

Complexity: Falls between the entry and full performance/senior level. Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices.

Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or that are without precedent are taken up with the supervisor.

Communications: Contacts with team members, clients or the public where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.

Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review.

Ability to Perform Essential Functions of the Job

PHYSICAL REQUIREMENTS

Vision - Near: clear vision at 20 inches or less

Weight Lifted/Force Exerted: up to 10 pounds/4.5 kilos, up to 1/3 of time

Hearing: able to clearly hear details

Sit: 2/3 or more of time

Talk: able to communicate verbally

Mental/Emotional: able to work in close proximity to others and/or in a distracting environment

Mental/Emotional: able to cope with stress effectively

Mental/Emotional: able to prioritize effectively

WORK ENVIRONMENT

Mental/Emotional: able to tolerate ambiguity

Mental/Emotional: able to prioritize effectively

Mental/Emotional: may be subject to many interruptions

Office Work Environment: Regular/frequent exposure

Bloodborne Pathogen Category 2: Occasional exposure to blood/body fluid

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.

Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.