1. Supports clinical departments in Revenue Cycle functions including, charging, reporting, edits and denials, charge reconciliation, compliance/regulatory updates, volumes/stats.
2. Works collaboratively with clinical departments and facilities to develop charges for new and revised procedures/programs which are compliant with regulatory requirements and internal policies.
3. Assists in the evaluation of current charging, coding and auditing processes in clinical areas and make recommendations to insure optimal and accurate charge capture and provide education, feedback and documentation to clinical area on identified issues to support correct charging and coding at the point of charge entry.
4. Demonstrates good understanding of federal, state and third-party charging guidelines to identify required changes to the CDM and provide guidance and education to departments on appropriate charging and coding practices.
5. Assists departments, including Patient Financial Service and Health Information Management, clinical departments, in resolving issues, edits, charging/billing errors or denials related to the charge master in accordance with regulatory guidelines and research issues, provide options and make recommendations to resolve identified issues.
6. Prepares reports on non-compliance or error trends and works with the departments to facilitate compliance, ensure appropriate revenue capture, and/or reduce Accounts Receivable (AR) through appropriate and efficient process flow.
7. Reviews current pricing as compared to Ambulatory Payment Classification (APC), Physician Fee Schedule (PFS) and market data. Provide back-up support to Patient Financial Services to provide procedure cost estimates in response to patient inquiries.
8. Quantifies and provides comparative data to understand impact of how changes to the charges will financially impact the department or facility.
9. Provide CDM/charge-related data/reports for decision-making support, as requested and within scope.
10. Role models the principles of a Just Culture and Organizational Values.
11. Perform other duties as assigned. Must be HIPAA compliant.

• 3 years of related revenue cycle experience required.
• 1 year Cancer Center Revenue Cycle experience required.
• CDM Experience in an acute care organization required.
• ICD/DRG and/or CPT/APC coding and reimbursement concepts knowledge required.
• Facility and/or professional coding and billing knowledge required.
• Knowledge of patient billing systems, health procedures and classification systems required.
• Knowledge of hospital accounting systems and practices as related to patient billing required.
• Proficiency in medical terminology, hospital charge masters, charge review, clinical record information systems, and coding methodologies required.
• Experience in a start-up environment preferred.
• Experience in implementing patient billing and accounting systems preferred.
• Experience with Cerner and Mosaiq preferred.

• N/A

• Radiation Oncology Certified Coder (ROCC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC/CPC-H), Certified Coding Specialist (CCS/CCS-P) or other HIM or Billing related certification preferred.

• Proficiency with Microsoft Office suite required.
• Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

• Graduate of a coding certificate program, associate or bachelor degree in health information technology, other allied health field, business or accounting preferred.

Benefits at Vail Health (Full and Part Time) Include:

• Competitive Wages & Family Benefits:
  • Competitive wages
  • Parental leave (4 weeks paid)
  • Housing programs
  • Childcare reimbursement 
• Comprehensive Health Benefits: 
  • Medical
  • Dental 
  • Vision
• Educational Programs: 
  • Tuition Assistance 
  • Existing Student Loan Repayment
  • Specialty Certification Reimbursement
  • Annual Supplemental Educational Funds
• Paid Time Off:
  • Up to five weeks in your first year of employment and continues to grow each year.
• Retirement & Supplemental Insurance:
  • 403(b) Retirement plan with immediate matching 
  • Life insurance
  • Short and long-term disability
• Recreation Benefits, Wellness & More:
  • Up to $1,000 annual wellbeing reimbursement
  • Recreation discounts
  • Pet insurance