This position is primarily responsible for performing quality assurance review of billing documentation and coordination of audit requests for UnityPoint at Home's Homecare and Hospice services. The incumbent must possess a strong understanding of regulatory standards and their impact on the provision of and reimbursement for home health products and services. This position has a direct impact on reimbursement and requires a high level of efficiency and a high degree of accuracy. The duties of this position include problem resolution and process improvement initiatives.

Quality Assurance

• Ensures the quality of billing information by verifying the completeness and accuracy of supporting documentation prior to submission of charges for reimbursement.
• Accesses patient records in multiple software systems, research conflicting information and facilitate the procurement of appropriate documentation to update UPAH records to support reimbursement.
• Monitors and works various reports such as the billing error report, bill hold report, ABN reports, face to face documentation reports, orders queues, etc.
• Tracks incomplete information and communicates feedback to management and intake staff.
• Extends a high level of customer service to patients, providers, external and internal customers while resolving issues that impact regulatory documentation requirements & accounts receivable.

Quality Improvement

• Retrieves, coordinates and tracks audit and documentation requests from payers to facilitate timely response and minimize the risk of negatively impacting billing privileges or appropriate reimbursement.
• Maintains appropriate audit trails to document and justify actions taken.
• Monitors trends on errors and communicates with internal departments and service lines affected
• Continues to maintain and update processes within department and work with homecare and hospice departments on any changes

Departmental Support

• Works with physician's offices for timely and accurate completion of face to face documents.
• Works with clinicians, clinical supervisors, and patient care coordinators for accuracy of chart documentation including, orders, face to face documentation, OASIS, HIS, etc
• Follows up with physician's office on any discrepancies or incomplete information.
• Updates physician information in all billing systems
• Manage clinician i-phones, travel requests, company p-cards, and other duties as assigned.

Education:

High school or vocational school graduate or an equivalent combination of education and experience.

All staff are expected to participate in appropriate continuing education as may be requested and/or required by their immediate manager. In addition, staff are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities. All staff must attend mandatory educational programs.

Experience:

3-5 years progressive experience in a business setting

Current knowledge of Medicare and Medicaid standards and guidelines and regulations related to commercial insurance companies and private payers

Proficiency with word processing and spreadsheet software

Experience Preferred:

Project coordination, sales, or information systems

Experience in a Home Health billing or compliance role

License(s)/Certification(s): Valid driver's license when driving any vehicle for work-related reasons.

Knowledge/Skills/Abilities:

• Strong interpersonal skills
• Strong verbal and written communication skills
• Ability to work as a collaborative team member.
• Ability to understand and apply guidelines, policies and procedures
• Ability to acquire information to address issues at hand to ensure regulatory compliance
• Ability to work in a fast paced, ever-changing environment
• Demonstrated analytical skills
• Detailed oriented, well-organized and able to work independently
• Exceptional written and verbal communication and interpersonal skills

Physical Requirements; Exerting up to 20 pounds of force occasionally or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Requires walking or standing to a significant degree, pushing or pulling arm or leg controls or maintaining a production rate pace. Light work requires physical exertion of forces greater than that of sedentary work.

Why UnityPoint Health?

• Commitment to our Team - For the third consecutive year, we're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare for our commitment to our team members.
• Culture - At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
• Benefits - Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you're in.
• Diversity, Equity and Inclusion Commitment - We're committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
• Development - We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
• Community Involvement - Be an essential part of our core purpose-to improve the health of the people and communities we serve.

Visit https://dayinthelife.unitypoint.org/ to hear more from our team members about why UnityPoint Health is a great place to work.