The Permanente Medical Group, Inc. (Kaiser Permanente Northern California)
Northern California, California
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This position is responsible for reviewing, auditing and reporting on charge capture at the department level, completing charge reconciliation, analyzing and resolving claims' denials and unbilled claims' issues, performing audits on department patient accounts, supporting Revenue Integrity initiatives on behalf of the department, and ensuring billing compliance
Responsibilities:
Reviews, audits and reports on departmental charge capture, performs charge reconciliation on a regular basis, and works closely with department staff on timely charge capture
Performs timely reviews of patient accounts and remittances for denials in order to determine root cause and appropriateness, and leads corrective action plans
Analyzes and resolves claims' denials and unbilled claims, including posting debits and credits to patient accounts
Facilitates selection of patient encounters for review prior to and after patient billing for purposes of performing audits and verification of billing compliance
Performs various analysis and provides reports to determine trends, compliant billing, impact to net revenue, and other analytical requests pertaining to revenue cycle
Works in concert with Revenue Management Team members and Revenue Integrity team at the hospital to ensure timely gathering and reporting of applicable data Interacts and works with Revenue Cycle departments (i.e. HIM, Patient Access, PFS, and Compliance) on revenue management initiatives and process improvement opportunities
Requirements:
High School Diploma
Work Type:
Full Time
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CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.
