OverviewThis position is primarily responsible for performing quality assurance review of billing documentation and coordination of audit requests for UnityPoint at Home's Homecare and Hospice services. The incumbent must possess a strong understanding of regulatory standards and their impact on the provision of and reimbursement for home health products and services. This position has a direct impact on reimbursement and requires a high level of efficiency and a high degree of accuracy. The duties of this position include problem resolution and process improvement initiatives.
ResponsibilitiesQuality Assurance
- Ensures the quality of billing information by verifying the completeness and accuracy of supporting documentation prior to submission of charges for reimbursement.
- Accesses patient records in multiple software systems, research conflicting information and facilitate the procurement of appropriate documentation to update UPAH records to support reimbursement.
- Monitors and works various reports such as the billing error report, bill hold report, ABN reports, face to face documentation reports, orders queues, etc.
- Tracks incomplete information and communicates feedback to management and intake staff.
- Extends a high level of customer service to patients, providers, external and internal customers while resolving issues that impact regulatory documentation requirements & accounts receivable.
Quality Improvement
- Retrieves, coordinates and tracks audit and documentation requests from payers to facilitate timely response and minimize the risk of negatively impacting billing privileges or appropriate reimbursement.
- Maintains appropriate audit trails to document and justify actions taken.
- Monitors trends on errors and communicates with internal departments and service lines affected
- Continues to maintain and update processes within department and work with homecare and hospice departments on any changes
Departmental Support
- Works with physician's offices for timely and accurate completion of face to face documents.
- Works with clinicians, clinical supervisors, and patient care coordinators for accuracy of chart documentation including, orders, face to face documentation, OASIS, HIS, etc
- Follows up with physician's office on any discrepancies or incomplete information.
- Updates physician information in all billing systems
- Manage clinician i-phones, travel requests, company p-cards, and other duties as assigned.
QualificationsEducation:
High school or vocational school graduate or an equivalent combination of education and experience.
All staff are expected to participate in appropriate continuing education as may be requested and/or required by their immediate manager. In addition, staff are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities. All staff must attend mandatory educational programs.
Experience:
3-5 years progressive experience in a business setting
Current knowledge of Medicare and Medicaid standards and guidelines and regulations related to commercial insurance companies and private payers
Proficiency with word processing and spreadsheet software
Experience Preferred:
Project coordination, sales, or information systems
Experience in a Home Health billing or compliance role
License(s)/Certification(s): Valid driver's license when driving any vehicle for work-related reasons.
Knowledge/Skills/Abilities:
- Strong interpersonal skills
- Strong verbal and written communication skills
- Ability to work as a collaborative team member.
- Ability to understand and apply guidelines, policies and procedures
- Ability to acquire information to address issues at hand to ensure regulatory compliance
- Ability to work in a fast paced, ever-changing environment
- Demonstrated analytical skills
- Detailed oriented, well-organized and able to work independently
- Exceptional written and verbal communication and interpersonal skills
Physical Requirements; Exerting up to 20 pounds of force occasionally or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Requires walking or standing to a significant degree, pushing or pulling arm or leg controls or maintaining a production rate pace. Light work requires physical exertion of forces greater than that of sedentary work.
Why UnityPoint Health?
- Commitment to our Team - For the third consecutive year, we're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare for our commitment to our team members.
- Culture - At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
- Benefits - Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you're in.
- Diversity, Equity and Inclusion Commitment - We're committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
- Development - We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
- Community Involvement - Be an essential part of our core purpose-to improve the health of the people and communities we serve.
Visit https://dayinthelife.unitypoint.org/ to hear more from our team members about why UnityPoint Health is a great place to work.
- Area of Interest: Business Professionals;
- FTE/Hours per pay period: 1.0;
- Department: Administrative Support;
- Shift: M-F 8:00am-4:30pm Remote;
- Job ID: 147391;