Central Florida Health Job - 39522473 | CareerArc
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Company: Central Florida Health
Location: Leesburg, FL
Career Level: Entry Level
Industries: Healthcare, Pharmaceutical, Biotech

Description

Position Title: Coordinator, Charge Auditor/Den Mgt.

Essential Functions: This is an experienced professional with hospital clinical experience with a strong understanding of clinical documentation, case management, and basic hospital reimbursement. Coordinates and performs medical necessity reviews of pre-bill APC services, denied services, line item charge and post payment audits.  Responsible for writing complete and comprehensive clinical medical necessity and DRG appeal letters. Assists Denials Team to identify root cause of denials and track and trend hospital denials while exploring corrective action including but not limited to inter/intradepartmental training and provider education. Performs chart audits to reconcile all detailed charges with clinical documentation within the electronic medical record.

Educational Requirements / Qualifications:

  • Associates Degree Required
  • Bachelor's Degree Preferred

Licensure/Certification/Registration

  • Florida Registered Nurse License

Special Skills/Qualifications/Additional Training/Experience Required

  • 5 years clinical experience to include clinical documentation, chart audits, ICD10 & ICD9 coding, hospital case management and/ or insurance care management.
  • Strong working knowledge of denials management, appeal submission, account reconciliation, and medical necessity i.e. LCDs and NCDs.
  • Excellent analytical, critical thinking and communication skills e.g. written and verbal.
  • Knowledge in clinical documentation, case management criteria and governmental and payer reimbursement methodologies.
  • Solid understanding of HIPAA, Hospital billing rules and regulations, Revenue Cycle processes and procedures.
  • Must be able to read, write, speak and understand English.

Who We Are:
UF Health Central Florida, formerly known as Central Florida Health and acquired by University of Florida Health in January 2020, is an award-winning, locally owned and governed not-for-profit health care system and the largest, most comprehensive provider of health care services in the region. We care for patients in Lake, Sumter, and Marion counties through inpatient acute hospital services at UF Health The Villages® Hospital and UF Health Leesburg Hospital, inpatient rehabilitation services at UF Health The Villages® Rehabilitation Hospital, adult inpatient psychiatric services at the UF Health Leesburg Hospital Senior Behavioral Health Center and diagnostic laboratory services at several locations.

As a premier health care provider, UF Health Central Florida takes pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve.  Check out our available jobs and apply today! To learn more, visit www.CentralFloridaHealth.org.


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