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Coordinator Revenue Integrity Home Health Mercy Health

Job ID: 4671542
Updated: December 6, 2018
Geographic Location: HomeOffice
Department: Home Health Svc Admin
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40

Job Summary

MISSION:

The mission of Mercy Health Partners is to extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and under-served.

  

SUMMARY OF JOB RESPONSIBILITIES:

The HMHHS Revenue Integrity Coordinator functions under the direction of the Assistant Director Revenue Cycle, and is responsible for analyzing all aspects of the revenue cycle (from billing to cash collections) for HM Home Care, HM Home Medical Equipment and HM Home Pharmacy.  Takes appropriate steps to ensure correct collection of revenue according to all Medicare, Medicaid and Third Party Payor contracts for all services rendered and products delivered.

 

Qualifications - Minimum

 EDUCATION:

Associate degree in related field or equivalent work experience.

  

EXPERIENCE:

Five years health related field with two or more years with patient financial services.

Experience in Post Acute Care setting preferred.

Experience analyzing financial reports required.

Experience with computers required, using various programs including MS Word, Excel, Lotus Notes or similar email program.

Working knowledge use of office machines (i.e. fax, scanner, and copier).

  

KNOWLEDGE AND SKILLS:

Proficient in use of MS Word and Excel (capable of obtaining a satisfactory score on proficiency tests).  Ability to analyze financial/billing reports.   Demonstrates leadership qualities including self-directed time management, verbal and written communication skills, listening skills, problem solving, decision making, priority setting, multi-tasking, work delegation, problem solving, and work organization.

  

PROBLEM SOLVING/DECISION MAKING:

  • Is capable of identifying problems and assessing the causes of problems independently.
  • In the absence of leadership, is capable of making decisions that maintain the support of all policies, procedures, and regulation.
  • Makes decisions with the best possible outcome for patients and HMHP on a regular basis.

  

SCOPE OF IMPACT/ACCOUNTABILITY:

  • Must be knowledgeable of the entire post acute billing process to understand potential impact on revenue integrity.
  • Accepts that following HMHHS standards, policies, and procedures is critical for success and will consult with leadership to solve opportunities for improvement.

  

INTERPERSONAL COMMUNICATION:

  • Must be able to maintain professional demeanor. 
  • Must be able to get along with colleagues, patients, visitors, physicians, and other professionals/paraprofessionals. 
  • Responsible to promote good interpersonal and inter/intradepartmental relationships. 
  • Must respect dignity of each person; respond on a timely basis to requests for information and creates an atmosphere of tolerance and understanding

 

PRINCIPAL JOB ACCOUNTABILITIES:

  • Responsible for accuracy of billing and cash receipts for all services provided by HMHHS.
  • Analyzes billing/cash collection/financial reports.
  • Maintains knowledge of all HMHHS third party payor contracts and updates as they occur.
  • Updates contractuals for third party payors in billing software:  Reimbursement rules in Horizon Home Care and Special Price Matrix in CPR+.

 

  • Educates HMHHS staff on contracts and contract changes for third party payors.
  • Assists with billing audits to ensure accuracy and completeness of required documentation.
  • Maintains current knowledge of Medicare and Medicaid reimbursement and regulatory issues and serves as a resource to Home Health Services staff and HMHP ancillary departments.

 

  • Assists with completing billing audits received from Medicare, Medicaid and other Third Party Payors (RACS, ADR, ZPIC).

 

  • Assists with HMHHS A/R issues special projects.
  • Takes an initiative to learn new skills, willing to participate and share expertise on required projects, committees, and other activities. 

 

  • Assists in training staff during orientation and on an ongoing basis. 

 

  • Offers technical expertise to all employees on new procedures and policies.  Serves as a resource for employees by answering questions and assisting with special or complex problems.

 

  • Recognize own limitations and seeks help from appropriate sources when necessary

 

  • Assists the Home Health Services Management Team with project/process development. Collaborates with Home Health Services in the planning and evaluating steps responsible for implementing these initiatives.

 

  • Recognizes and rewards the successes of others.
  • Assist staff in attaining professional and department goals.
  • Identifies areas of concern and addresses the issue in a professional manner.
  • Maintains department resources in a manner consistent with department budgets and departmental activity.

 

  • Assists with billing as necessary.
  • Performs other duties as assigned.

 

JOB ACCOUNTABILITIES – Other:

  • Provides high-level of customer service. 

 

  • Demonstrates a willingness to assist and ability to fully resolve issues in a timely fashion.

 

  • Participates in and contributes to staff meetings.

 

Hours

Hours per pay period: 80

Hours: 8:00am to 4:30pm

 

Shift and Job Schedule

Job Shift: Days, Job Schedule: Full-Time

 

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

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Date Last Modified: 9/11/2018 4:00:00 PM