Registered Nurse Practice Area Specialist Full Time Days Tampa

Practice Area Specialist AdventHealth Tampa

Location Address: 3100 East Fletcher Avenue Tampa, Florida 33613

Top Reasons to Work at AdventHealth Tampa

• Florida Hospital Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
• Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
• Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
• Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.

Work Hours/Shift:

• Full Time/ Days

You Will Be Responsible For:

• Analyzes price and billing for specialty areas and reports results to manager.
• Works closely with Financial Services/HIM/Finance to research and correct specific problem accounts or areas.
• Monitors charge accuracy levels for all revenue producing departments.
• Makes process improvement recommendations to departments that have been audited.
• When requested, leads out in charge accuracy improvement meetings that address specific process and charge issues, providing regular updates to RI Director.
• Charge questions that are raised by departments will be researched with the involvement of the corporate CDM/HIM/PFS departments to ensure that the issue is addressed by the proper individuals at the corporate office.
• Utilizes the corporate charge master manual as a guide for CDM
• Assists with report findings from the assigned clinical work queues, erroneous or missing charge postings with following up analysis, development, and implementation of recommendations and actions plans to minimize late or missing charges. Provides results to RI Manager, Director and Clinical Directors.
• Works with the Revenue Integrity Manager to document and report findings, provide education and develop recommendations and actions for clinical departments.
• Assists with analytical support to process analysis, denial analysis, charge lag analysis, underpayment analysis and missing charge analysis and all other aspects of revenue cycle.
• Runs assigned reconciliation reports (e.g. Revenue Reconciliation Monitoring Reports, Encounter Charge Reconciliation Reports, etc.) that will be used to identify charge related opportunities.
• Work closely with individual facilities Leadership/clinical staff to establish and maintain positive relations to ensure revenue integrity goals are achieved.
• Maintain working knowledge of CPT and HCPCS coding as well all billing, CCI, MUEs, and other relevant coding/billing guidelines.
• Performs manual charge entry if needed when possible missing charges are identified as instructed by RI Manager.
• Advanced skills in organizing and presenting information in a systematic format using spreadsheet and graphing capabilities. Skills in documenting performance flowcharts, summaries, and presentation formats.
• Excellent communication skills in both written and verbal formats
• Thorough knowledge of current trends and best practices in performance improvement and revenue cycle concepts, applications and methods.

What You Will Need:

• Ability to interact with the Hospital Financial Department, HIM Leaders, URM and Revenue Integrity leaders.   
• Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time.
• Knowledge of ICD-10 and CPT Coding Principles as well as billing methodologies. Knowledge of computer system includes Windows, Excel, Cerner Clinical and Cerner Patient Accounting billing systems. Ability to communicate effectively in writing and verbally. Must be effective in creating and analyzing spreadsheets/reports.
• Regular contact with clinical and financial Leadership.
• The Practice Area Specialist has access to institutional financial goals and ongoing reports supporting the achievement and benchmarks of the Finance Committee. The Practice Area Specialist has the responsibility to adhere to the Florida Hospital Corporate Compliance plan, to the rules and regulations of all local, state, and Federal agencies, and to the standards of all accrediting bodies.
• Must be adaptable and flexible as required
• Regional Travel =/> 50% may be required
• Associate RN for OR or CCL/Radiology Specials Tech with Registered Cardiovascular Specialist Credential (RCIS) for Radiology.
• 3 years of experience in facility billing, coding, patient accounting or business OR three years acute care hospital experience or working in a Clinical/Outpatient setting.
• Experience in a role related to revenue capture/charging, auditing, coding or compliance.
• Experience with PCs, word processing, spreadsheet, analytics, and database software
• Strong quantitative, analytical and organization skills.
• Ability to understand and interpret medical records, hospital bills and the charge master.
• Excellent written and verbal communications skills.
• Excellent critical thinking skills.
• Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff and hospital leadership.
• Current Florida License as an RN OR Registered Cardiovascular Invasive Specialist (RCIS)

Job Summary:

• The Practice Area Specialist will ensure that the charges that are generated in the Cerner Clinical system are being properly recorded and documented by clinical areas and provide direct feedback to clinical leaders as approved by Revenue Integrity Manager/Director. The Practice Area Specialist will work closely with Financial Services, Patient Accounting, Coding, HIM and URM departments to review and communicate any areas of opportunity found in OR/Radiology Departments of Tampa Region. Complex charge issues that require research may be referred to this position by HIM, URM, Coding and Revenue Integrity (RI). This position will be responsible for participating in and occasionally chair meetings that address process improvement initiatives related to charge/documentation accuracy levels. Responsible for auditing multiple operational areas as directed by RI Manager. Practice Area Specialist is responsible for providing assistance in maintaining systems, processes and work flows, for the timely and accurate recording of hospital revenue in regard to charge capture. This position supports the Manager of Revenue Integrity and serves as a facility liaison to the AdventHealth System (AHS) Leadership as it relates to charge capture/billing concerns. The analyst will assist in upholding AHS administrative and fiscal excellence within Revenue Cycle by providing expertise to assist and educate Clinical Departments on charging efficiencies ensuring payment integrity and the accuracy of charging practices. The Practice Area Specialist is responsible for reviewing the charges and coding all designated services provided in various settings including the surgery department and/or radiology in compliance with AHS policies.  This position provides Tampa Regional coverage and supports AdventHealth Tampa, LTAC, North Pinellas, Carrollwood, Dade City, Ocala and Wesley Chapel.  Any other off-site surgery and/or radiology facilities will be covered as brought on board.