Job Description

LOCATION:  WICKENBURG, AZ

Wickenburg Community Hospital is a beautiful and sophisticated rural-access hospital located in Wickenburg, Arizona.  WCH is a 8-bed Emergency Department, 19-bed Acute department and many ancillary services.  We also have 3 Primary Care Clinics.  Here at WCH, we strive to maintain the highest standards of professionalism and care.  Join us today and let us be part of your success story.

We offer:

  • Full Benefits
  • PTO/Sick Leave
  • Wellness Benefits

Wickenburg Community Hospital is a non-profit organization and qualifies for the Public Service Loan Forgiveness (PSLF) program.

GENERAL DESCRIPTION:
The job description for a Charge Capture & Compliance Professional outlines a role that is crucial in ensuring the accurate capture and compliance of patient charges within the healthcare industry. The professional in this role works to reconcile charges, ensure billing accuracy, maintain compliance with coding regulations, and contribute to the improvement of revenue capture processes. This professional serves as the main point of contact for compliance concerns and works with applicable departments to resolve investigations.

ESSENTIAL JOB DUTIES:
• The professional ensures that all patient-related charges are entered accurately and promptly, which is essential for proper billing and revenue capture.
• The role involves reviewing clinical documentation to identify any missing charges or discrepancies that may affect billing and revenue.
• A critical task is maintaining and updating the hospital’s chargemaster, which contains a list of all the services and their associated costs.
• The professional identifies opportunities to streamline and improve the workflow of charge capture processes, enhancing efficiency and accuracy.
• Regular auditing procedures are conducted to ensure all departments adhere to billing and coding standards, identifying any potential areas of concern.
• The professional provides training to staff on correct billing data entry practices and charge capture procedures to ensure accuracy and compliance.
• The role requires staying informed on current billing, coding, and compliance standards, ensuring that the organization adheres to the latest regulations.

Compliance:
• Maintain the WCH compliance program that aligns with our strategic goals and regulatory requirements, ensuring effective management of compliance risks across the organization.
• Monitor and ensure compliance with federal and state regulations.
• Lead internal investigations into potential compliance violations, addressing issues promptly and effectively, and implementing corrective actions as necessary.
• Oversee the preparation and submission of compliance reports to regulatory bodies, ensuring accuracy and timeliness. Maintain comprehensive documentation of compliance activities and issues.
• Serve as the primary point of contact for regulatory agencies and external auditors, managing relationships and facilitating audits and inspections.

OTHER (NON-ESSENTIAL) DUTIES:
• Maintain working relationships across departments.
• Attention to detail is paramount. The ability to spot discrepancies and ensure that charges are accurately captured.
• Strong ability to collaborate with different departments and provide training and feedback.
• The ability to address discrepancies, compliance issues, and inefficiencies within the charge capture process.

MINIMUM QUALIFICATIONS:
• Ability to utilize resources in an organized manner (including technological resources and programs)
• Effective interpersonal and customer relation skills
• Proven computer skill is necessary with the use of electronic medical records programs.
• Proven working knowledge medical terminology
• Proven working knowledge and experience with Microsoft office and other computer software
• 2 years of experience with ICD-10-CM, CPT, HCPCS
• Training and certification in healthcare billing.

PREFERRED QUALIFICATIONS:
• 5 years in healthcare billing.
• Compliance Certificate preferred.

PHYSICAL REQUIREMENTS/WORKING CONDITIONS:
• Sitting for extended periods of time
• Lifting of 25 lbs.

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