Job Description

JOB SUMMARY:
Provide leadership and oversight of the overall patient care activities that ensure the highest quality and cost effective service. To ensure compliance with protocols of regulatory bodies, accrediting agencies, and reimbursement agencies. Oversees the operational management of services and staff of all three areas.


EDUCATIONAL REQUIREMENTS

• Bachelor's Degree

EXPERIENCE REQUIREMENTS

• 3-5 years of experience in/with Cath Lab and/or Cardiac Surgery Services

ADDITIONAL REQUIREMENTS

• Use of usual and customary equipment used to perform essential functions of the position.

SKILLS AND KNOWLEDGE

• Writes, reads, comprehends and speaks fluent English.
• Basic computer knowledge using word processing, spreadsheet, email, and web browser.
• Multicultural sensitivity.
• Critical thinking skills using independent judgement in making decisions.

ESSENTIAL FUNCTIONS:

• Enhance fiscal responsibility in the Cardiovascular Services Department
• Ensure effective systems for reimbursement, monitoring compliance with Medicare and other reimbursement agencies.
• Monitors patient charges and assists in resolving patient billing issues
• Facilitate accurate and timely computer-based patient billing.
• Coordinates charging functions for supplies, equipment, and services.

• Supervises Department Coder for accurate and timely entering of charges and audits of charge journal.
• Analyses management reports for usage and cost.
• Updates supply charges on an ongoing basis.
• Facilitates reimbursement for expenses by communicating current reimbursement regulations appropriately.
• Resolves billing issues as it relates to the Cardiovascular Services Department.

• Effects positive interactions with the Patient Accounts and Finance departments.
• Functions autonomously and claims ownership for service represented.
• Collect data and prepare reports (utilization reports, statistics, and financial analysis) as requested
• Enhance the daily operation of the department.
• Maintains the department Chargemasters which includes developing charges for supplies and procedures.

• Serves as the Cardiology representative on the Chargemaster Committee.
• Continuous communication with Patient Accounts
• Ensure AR is met and denials are reviewed and addressed in a timely manner.
• Works with Patient Accounts
• Ensure appeals for reimbursement are prepared correctly and appropriate documentation is present.

• Educate physicians on topics concerning documentation, CPT, codes, and ICD-9 codes.
• Enhance fiscal responsibility in the Cardiovascular Services Department
• Ensure effective systems for reimbursement, monitoring compliance with Medicare and other reimbursement agencies.
• Monitors patient charges
• Assists in resolving patient billing issues to facilitate accurate and timely computer-based patient billing.

• Coordinates charging functions for supplies, equipment, and services.
• Supervises Department Coder for accurate and timely entering of charges and audits of charge journal.
• Analyses management reports for usage and cost.
• Updates supply charges on an ongoing basis.
• Facilitates reimbursement for expenses by communicating current reimbursement regulations appropriately.

• Resolves billing issues as it relates to the Cardiovascular Services Department.
• Effects positive interactions with the Patient Accounts and Finance departments.
• Functions autonomously and claims ownership for service represented.
• Collect data and prepare reports (utilization reports, statistics, and financial analysis) as requested
• Enhance the daily operation of the department.

• Maintains the department Chargemasters which includes developing charges for supplies and procedures.
• Serves as the Cardiology representative on the Chargemaster Committee.
• Educate physicians on topics concerning documentation, CPT, codes, and ICD-9 codes.
• Monitors inventory and assists in purchasing of new products and equipment.
• Prepares departmental budgets and manages departmental resources

• Uses financial, productivity and outcome data to ensure effective of costs
• Meets the fiscal objectives of the organization.
• Demonstrates understanding of various expense and revenue accounts.
• Demonstrates knowledge of payer and reimbursement factors that impact the operating budget.
• Prepares and monitors budgets which reflect Methodist fiscal philosophy

• Identifying resource needs of the department.
• Prepare department operations budget
• Analyze operating needs, projected revenue and expenses, and manages capital expense budget as required.
• Use outcome data to determine resource needs

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