Department: Patient Registration
Shift: 1st Shift
The purpose of this position is to identify, monitor, and resolve various regulatory issues. Specifically, this position will be responsible to identify prior to service scheduled patient tests or procedures which have medical necessity criteria and verify that there is adequate diagnosis information. This position will work with the physicians’ offices, patients, and internal departments to resolve inadequate diagnosis information. As policies are continually updated and revised by HCFA and other payers, this position is responsible for continued updating of our internal check and ongoing staff education.
This position is also responsible for identifying problematic outpatient claims related to APC assignment through the use of specific software and reports. This position will work with Medical and patient accounts to resolve coding assignments which fail APC checks.
This position will also have primary responsibility as a liaison with other hospital departments for education and monitoring relates to compliance concerns. This position is under the supervision of the department supervisor.
Advanced education and training to include both clinical/medical knowledge and understand of financial issues.