The Outreach Hospital Coordinator primary office site is the Shady Grove location and is responsible to complete services required to ensure we accurately capture necessary information to charge and bill for our services at outside partner hospitals. The Outreach Hospital Coordinator serves as a liaison between Children's National physicians and the billing team. The Outreach Hospital Coordinator will ensure accurate and timely charge capture and quality assurance processes for professional charge services which are completed daily. The Outreach Hospital Coordinator will work directly with physicians, registration, billing, Managed Care, and outreach hospital staff to ensure an efficient and seamless process to support charge capture, billing, and reimbursement. Minimum Education
Associate's Degree (Required) Or
Bachelor's Degree (Preferred)
Minimum Work Experience
3 years Experience with medical billing process, health care insurance claim practices and compliance (Required)
Required Skills/Knowledge
Basic knowledge of professional CPT codes related to hospital based services required to ensure procedure and diagnosis codes are billable prior to entering charges; correspond with physicians to report coding issues.
Functional Accountabilities
Liaise between Children's National physicians and the billing team.
Demonstrate accuracy of registering patients using the applicable system for the department.
Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy.
Verify insurance eligibility using applicable eligibility system. Contact patients to obtain insurance information if necessary.
Follow all established departmental policies to perform preliminary review of source reports to determine sufficient data are present to manually post or upload and process charges.
Work collaboratively with all departments/services of the Children's National Health System to ensure any needed information is obtained for billing process. Ensure an efficient and seamless process to support charge capture, billing, and reimbursement.
Perform auditing of charges to identify any errors; address this information directly with the departments, managers and/or physicians.
Conduct root cause analysis for issues reducing reimbursement and slowing payment cycle; identify key issues and assist with tracking, trending and reporting.
Present data and analysis to all levels of management and/or physicians for trends and billing issues.
Assist in the development of solutions, training and education to resolve issues and share data with staff and management.
Provide training and education to new employees and leadership as needed.
Perform the duties listed above and other duties as assigned.
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication
Demonstrate collaborative and respectful behavior
Partner with all team members to achieve goals
Receptive to others’ ideas and opinions
Performance Improvement/Problem-solving
Contribute to a positive work environment
Demonstrate flexibility and willingness to change
Identify opportunities to improve clinical and administrative processes
Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
Use resources efficiently
Search for less costly ways of doing things
Safety
Speak up when team members appear to exhibit unsafe behavior or performance
Continuously validate and verify information needed for decision making or documentation
Stop in the face of uncertainty and takes time to resolve the situation
Demonstrate accurate, clear and timely verbal and written communication
Actively promote safety for patients, families, visitors and co-workers
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance