To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
This position will be the Clinical Charge Capture Specialist, reporting to the Senior Manager of Revenue Integrity for YNHHS, and responsible for a variety of System-wide reimbursement and revenue integrity functions, including reporting, analytical , technical and systems support. Additionally, involved with assisting in the revenue compilation for all System's hospitals and physician practices, reporting and analysis related to the financial statement close process and supporting internal stakeholders, including accounting, SBO and revenue reporting on a variety of revenue related issues. This person would also be responsible to help ensure accurate and timely capture and transfer of charges from hospital information systems. Other duties include the accurate establishment of clinical charges and billing code, researching and resolving charge system problems. Documents system performance, to ensure accuracy, compliance and to enhance revenue. Works as part of a multi -disciplinary team that includes billing, medical records, coding, compliance, clinical leadership, finance and information systems. This position will look to develop new opportunities for revenue enhancement including leading multi ?disciplinary work groups (Accounting, Reimbursement, Budget and Planning and the billing office) on projects associated with revenue data and reporting. Serves as technical lead in information systems, data analysis and other analytic needs related to revenue reporting and analysis. Assures the accuracy and accountability of reported revenue information.
- 1. Responsible for the preparation of the monthly revenue reporting and support related to net revenue and accounts receivable valuations.
- 2. Assists in the overall net revenue budget process, which includes assumptions and valuation, financial assessments and ad hoc reports, supporting documentation, filings and audits.
- 3. Develops new opportunities for revenue enhancement by analyzing reimbursement, billing and collections, as well as working with other departments to identify areas of revenue opportunity.
- 4. Streamline projects for routine, accurate production, as required. Adequately documents work and processes as required for use by others.
- 5. Supports development of large databases through the use of required data mining tools.
- 6. Coordinates efforts of multi-disciplinary groups responsible for projects involved in the management and enhancement of revenue, as required. At times, will be expected to lead these groups. Groups may include representatives from various clinical areas, Accounting, Coding, Medical Records Billing, and Utilization Management, Compliance and Information Systems and staff from other organizations. At other times, is required to work closely with clinical, Compliance and other Finance colleagues on a number of different revenue related projects.
- 7. Works to assure the accuracy and accountability of revenue information reported externally to outside auditors, governmental agencies and the public.
- 8. Analyzes current information, supporting documentation and data capture methods for purposes of identifying systematic and departmental opportunities for improvement and enhancement of revenue.
- 9. Responsible for the assisting in the completion of the monthly revenue reporting process. This includes the areas of maintaining detailed computer models, financial analysis and forecasting.
- 10. Researches charge system problems and makes recommendations for resolution. Assists in the development of tools required to understand, monitor and improve charge capture efforts.
- 11. Promotes the Vision, Mission, and Values of Yale New Haven Health.
- 12. Performs other duties as required.
Bachelor's Degree in business or related clinical discipline, or Licensed RN or Coding Certification (CPC/CCS) required.
With a Bachelor's Degree CCS Certification or Licensed RN, a minimum of five years experience in health care finance, billing, coding, direct clinical care, reimbursement, accounting, budget, compliance or insurance.
With a CPC - a minimum of eight years of professional work experience in medical coding or closely related field.
Knowledge of health care billing revenue process, accounting and auditing theory is required and assumed. Efficiency in Access and Excel is assumed. Assumes working knowledge in the field of health care, revenue reporting and/or reimbursement. Demonstrates ability to lead groups and work on numerous projects simultaneously.
No special demands.