How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Job Summary:
The incumbent will coordinate with staff and management to ensure timely resolution of Claim Edits and denials.
The Sr. Project Coordinator will also work directly with staff on charging, reimbursement, regulatory and revenue
related process issues. This encompasses working directly with clinical and billing staff to evaluate workflows
and develop strategies to integrate practices throughout the health system for the ultimate implementation of
standardizing the charging and billing process. The incumbent will be empowered to establish a continuous
improvement on processes that maximize the technical resources, enhance service delivery, standardize systems
and effect appropriate cost controls to ensure the health system's competitive position in the marketplace.
Core Responsibilities and Essential Functions:
Serve as coordinator for assigned ancillary departments
Assist and support Analysts in maintaining the chargemaster for assigned depts.
Oversee and monitor work queues for assigned areas
Maintain accuracy of all levels of coding in the chargemaster for assigned areas
Provide dept education on correct coding edits, reimbursement, regulatory changes and
compliance issues
Orient dept management and staff to role of RMD in relation to support provided.
Work with depts. on monitoring tools to assure revenue flow is not interrupted.
Keep dept management updated to changes which will affect the service line
Plan, design and implement processes which directly impact the performance of assigned depts.
Assist depts. with ways to streamline costs
Monitor dept revenue for set thresholds
Alert and troubleshoot fluctuations in dept revenue
When requested, serve as facilitator for dept process improvement projects.
Participate in development of new programs or services for hospitals
Obtain baseline information for new services such as CPT codes and reimbursement. Review
regulatory literature for areas that would impact the new service.
Work with accounting to set up new cost center if indicated
Develop new chargemaster
Address failed claims for assigned depts. on a timely basis
Analyze issues and determine fix
Work with Coding, Compliance and PFS on claims as needed.
Review regulatory bulletins and other communication to determine if permanent fix can be
implemented
Design and implement processes which affect the revenue cycle
Interpret and/or clarify Medicare bulletins and other regulatory documents.
Works jointly with PFS, PAS, Coding, Compliance, Medical Records, Internal Audi, Supply
Chain and the clinical departments as issues arise which affect the flow of billing and revenue
management.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
Additional License(s) and Certification(s):
Required Minimum Experience:
Minimum 5 years of practical coding experience with Revenue Cycle departments Required and
Minimum 5 years of department specific work experience in Revenue Cycle Departments, including
but not limited to Patient Financial Services or Revenue Management having
experience with system tables, complex reports, presentations and education. General to Intermediate knowledge of MS Office Professional. Required and
Epic, VISIO, Crystal, Business Objects, SQL and other reporting and/or tracking tools
preferred Preferred
Minimum 5 years healthcare related experience Required and
Chargemaster, Clinical (Nursing, Technologist, Ect) Required and
Revenue cycle experience Preferred
Required Minimum Skills:
Basic word/excel skills. Excellent written and verbal skills.
Must be organized and multi-task oriented.
Required Minimum Skills
Strong interpersonal, leadership and persuasiveness skills.
Must be comfortable interacting with physicians, senior management and directors.
Strong decision-maker, capable of handling high priority multi tasks.
Excellent presentation skills.
Strong performance skills and experience with an emphasis on change management.
Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.