Health and Public Service - Revenue Cycle Charge Capture CDM Subject Matter Advisor

Description

 

Location: Negotiable

 

Organization:  Health and Public Service

 

The Health & Public Service operating group serves health organizations, government agencies, institutions and nonprofit organizations worldwide providing a broad range of consulting, technology, system integration and business processing services.

 

Job Description

 

Consulting professionals at Accenture belong to one of three workgroups: Management Consulting, Systems Integration Consulting or Technology Consulting. These workgroups enable us to deliver the increasingly specialized skills that clients demand while providing our people with varied career opportunities.

 

Our management consultants have the opportunity to work and collaborate with colleagues from across the full spectrum of consulting activity: identifying and creatively solving complex problems, designing and re-engineering critical processes, and fundamentally transforming the way a company operates.  Our management consultants are more than just theorists - they turn theory into action.  Acting as trusted advisors to our clients, they work directly with FORTUNE© Global 500 companies across many different industry sectors.  They concentrate on getting a holistic view of a client's business and industry environment and use their expertise and critical thinking skills to design and deliver realistic, achievable business strategies and solutions that address key client priorities.

 

Much of the work we do is at the cutting edge of innovation and thinking.  We involve our consultants in publishing and sharing this knowledge as thought leadership to benefit clients, industry and fellow colleagues.

 

Responsibilities of the Revenue Capture Charge Capture CDM Subject Matter Advisor may include:

 

  • Conduct charge capture assessment activities, including
  • Interviews, outcomes analysis, process flows analysis
  • Chart Audit reviews
  • Direct clinical observations
  • Develop respective leading practice recommendations to support identified findings
  • Develop and implement process flows and policies/procedures to ensure timely and appropriate capture of all chargeable services
  • Includes developing working relationships with revenue producing departments, Finance, IT, and HIM to establish charge capture mechanisms and ensure orderly and timely recording of revenue
  • Design training material and conduct training sessions
  • Develop and implement Charge Reconciliation processes for interface reconciliation and leading practice order/charge reconciliation processes for ancillary departments
  • Build tools (reports and scorecard) for monitoring charge capture key performance indicators and recommend key metrics
  • Analyze Charge Description Master (CDM) to ensure it meets compliance standards
  • Provides technical expertise related to maintenance of CDM
  • Conduct detailed line-item review
  • Identify need for addition, modification or deletion of charge codes
  • Confirm all codes required for billing and reporting are current per annual and quarterly code set updates (AMA and CMS)
  • Review ancillary system item files to ensure linkages are accurate (e.g. supplies, pharmacy)
  • Develop policies and procedures to monitor consistency of charges throughout hospital
  • Conduct chart audits comparing documentation to the itemized bill to the UB-04
  • Identify coding issues
  • Recommend solution and implement corrective action to prevent future rejections/denials and to insure accurate and expedient reimbursement
  • Establish a Chart Audit Program (both concurrent and retrospective)
  • Calculate financial metrics for all revenue related opportunities
  • Ability to travel 100%

 

Qualifications

 

Basic Qualifications:

 

  • 1 year of clinical experience including chart audits and revenue cycle processes experience
  • 5 years of experience in billing and documentation systems and in general accounting principles
  • 1 year of experience with OPPS and NCCI edits

 

Preferred Skills:

 

  • Charge Description Master experience
  • Degree in Nursing or Medical Records Coding 

 

All of our consulting professionals receive comprehensive training covering business acumen, technical and professional skills development.  You'll also have opportunities to hone your functional skills and expertise in an area of specialization.  We offer a variety of formal and informal training programs at every level to help you acquire and build specialized skills faster. Learning takes place both on the job and through formal training conducted online, in the classroom, or in collaboration with team-mates.  The sheer variety of work we do, and the experience it offers, provide an unbeatable platform from which to build a career.

 

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Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.

Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa.

Accenture is an Equal Opportunity Employer.

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