Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Women's Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nation's five largest health care systems. Visit https://www.dignityhealth.org/socal/locations/californiahospital for more information.
This position manages the gross revenue activities for the clinic, including RVU review, Charge Audit, report preparation, HCPCS audits and reconciliation procedures, QA monitoring tool, and assistance with revenue-based statistics and related issues. Also responsible for charge capture processes, charge audit and subsequent charge review post procedure, and other duties/projects related to charge/revenue of the clinic as assigned. Is expected to perform duties in alignment with the mission and policies of the organization. Performs duties in support of and in compliance with the performance improvement plan, JCAHO and other licensing, accrediting and regulatory agencies. Conducts a daily review of electronic appointment scheduling system for routine visits, screenings, diagnostic testing, and procedures to confirm all patients' status has been updated to either arrived, canceled or no show; collaborates with the Clinic Operations Specialist to update any appointments that still show as scheduled. Responsible reviewing all billing tickets to ensure procedure and diagnosis codes (CPT/ICD-9) match the documentation and follows up with appropriate staff to review and correct any deficiencies. Reconciles the appointment schedule with completed billing tickets to ensure there is a corresponding billing ticket for all arrived patients. Reviews electronic and/or paper medical records to ensure all Physicians, Allied Health Providers and Registered Nurses have completed their documentation on a daily basis and that the coding matches the documentation. Proactively follows up with Physicians and Allied Health Providers and Registered Nurses to ensure any incomplete medical records are completed, signed and dated. Responsible for charge entry in the hospital billing system on a daily basis ensuring the entry reflects the completed facility billing ticket documentation; reviews charge posting reports to reconcile and confirm all charges are entered correctly and/or credit duplicate entry's and add missing charges consistent with clinical documentation. Develops and maintains an electronic filing system for all facility billing tickets. Assists with daily collections reconciliation; reviews all professional collections and hand delivers to each respective physician. Ensures all facility collections are delivered to the designated location at California Hospital Medical Center on a daily basis. Coordinates and manages all calls from patients regarding billing issues and/or concerns. Greets every patient in a warm, friendly, professional and courteous manner. Is proactive and dedicated to problem-solving and providing sound resolutions; facilitates and acts as a liaison with any callers regarding facility and professional billing. Collaborates and assists staff with calls regarding self-pay for services not covered by insurance. Provides approved charges for services, ensures financial agreements are signed and collects payments. Issues receipts and ensures all payments are entered in hospital's billing system and the electronic Health record and department logs as needed. Provides administrative support to the Operations Manager and Senior Director. Collaborates with the Senior Director, Operations Manager, and Revenue Cycle Manager to ensure Charge Description Master (CDM) are kept current and/or CDM is created for new services as they arise. Provides coverage for incoming calls, scheduling patients for appointments and surgery. Organizing and scanning paper medical records into the electronic health record. Collaborates with the Health Information Department to ensure that any missing documentation (i.e. In/Outpatient Surgery) is completed as soon as possible to ensure physicians are not suspended and/or minimal delay in records being coded and processed for billing by HIM staff.
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