Carondelet�s St. Joseph�s Hospital (located at 350 N. Wilmot Rd, Tucson, AZ 85711) provides a full range of comprehensive inpatient and outpatient services. Established in 1961, St. Joseph�s Hospital is a premiere medical campus serving Tucson and the Southwest. St. Joseph�s is home to the Carondelet Neurological Institute and the Carondelet Joint Replacement Center. Here you�ll find one of the region�s most comfortable labor and delivery units as well as high-quality care and customer service in programs such as cardiology, orthopedics, oncology, wound care, stroke, diabetes, emergency medicine and rehabilitation. The 486-bed facility is an accredited Chest Pain Center, has been recognized by the American Heart and Stroke Association with a Get with the Guidelines Award for stroke care, and has nationally-certified Cardiac and Pulmonary Rehabilitation Programs.
When you join Carondelet�s Community Built on Care, our family of nurses, doctors, staff and healthcare specialists are dedicated to providing expert, compassionate care for all the families of Southern Arizona and the surrounding communities. We�ve been caring for you and your loved ones for more than 135 years � right here, in this great community of ours. So this is our home too. Caring, nurturing and helping heal friends, loved ones and neighbors of Southern Arizona is our passion, and we�re honored to have the opportunity to serve you. From emergency services and heart care to orthopedics, advanced stroke treatment and more, we�re focused on providing you with expert care combined with a healthy dose of attentiveness and kindness. Carondelet Health Network. A community built on care.
POSITION SUMMARY
This position reviews all surgical records and enters post case surgical logging into the system to ensure correct billing and case information so analyses can be made to evaluate case loads, costs, information by Physician, etc. Serves as liaison to Materials Management, Infection Control, Finance-Revenue and physician/clinic offices. Ensure charge appropriateness and documentation requirements have been met for all services performed on a daily basis to ensure optimal billing, reimbursement, and compliance. Incumbent has routine contact with internal department directors, physicians regarding reimbursement with third party payers to maintain up to date information. External contact consists of federal agencies and patients. Incumbent is responsible for maintaining current knowledge of compliance requirements relative to regulatory third party reimbursement and educating specific CHN department heads as appropriate.
POSITION DUTIES
Verifies accurate data on Perioperative Clinical Record and Charge Records.
Cross references to the previous day�s surgery schedule to ensure complete surgical records including charges for implants and required implant records.
Identifies documentation issues for immediate resolution of potential missed revenue and incomplete charting.
Works with OR Manager and OR Materials Coordinator to ensure all information is correct and present; works with Surgical Educator to improve quality and accuracy of charge documentation by OR nursing associates.
Works with Materials Coordinator to ensure invoices submitted by sales reps are correct and match what was documented in the OR record; works with Clinical Nurse Leaders to gather and interpret statistical data for their service lines.
Enters post case logging and charges; works closely with revenue integrity and surgery scheduling to ensure cases are booked correctly with appropriate CPT codes.
Ensures case volume data entered is correct; charges are entered using designated procedure codes.
Generates daily, monthly, and ad-hoc reports.
Daily reviews previous day�s surgery schedule. Collects appropriate documents from pharmacy, radiology, materials management, eye center and surgery and collates the data for each patient�s record.
Enters data into databases, spreadsheets and systems used within the departments.
Retrieves statistical data and information as requested.
Uses report writers to prepare develop reports for management review.
Audit patient records to ensure all surgical costs were captured correctly. This requires at times reviewing physician� dictation to confirm any issues that might appear.
Send corrections for patient records back to the RN in charge.
Analyzes requests for proposal and provides usage information and can provide by service line and product.
Level 2 � Proficient (in addition to above duties)
Runs reports for surgeons, first assists and some physician offices as requested to verify patient information/cases performed. .
Provides advice regarding preference cards when it has been identified that some items are no longer being used or products have changed.
Level 3 � Subject Matter Expert (in addition to above duties)
Knowledgeable of all surgical procedures and can identify errors or items that have not been included in charges.
Provides feedback into CDM changes or procedure leveling as requested.
Educates clinical units regarding reimbursement issues and communicates to ensure compliance with regulatory requirements.
EDUCATION
Required: High School Diploma or General Education Diploma (G.E.D.)
with medical terminology, anatomy, and physiology.
Preferred: Bachelor�s degree in Business, Finance or Healthcare related field desired
Certificates
Preferred: Certified Coder
Experience
Required: Three (3) years� experience in medical reimbursement, insurance, auditing, or utilization review.
Preferred: Five (5) years working in surgery with knowledge of hospital environment desired.
Skills
Required: Verbal and written communication skills. Team building, problem solving, critical thinking, interpersonal communication, detail oriented and accountability.
Knowledge
Required: Basic knowledge of CPT-4 and ICD-9 coding
Preferred: Knowledge of Medicare, Managed Care, and other 3rd party payer as related to hospital operations. Knowledge of fiduciary responsibilities as related to the laws, rules and regulations as defined by the Federal, State and JCAHO statues.
Technology
Required: Personal computer skills, including Windows and Microsoft office products
Preferred: Knowledge of Meditech, ESP or similar health care computer system.
Other
Required: Positive attitude
Preferred: Bilingual
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Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
