Job Details
Type: Full Time
Post Date: 30+ days ago
Industry: Other
Job Description
KEY ROLE ACCOUNTABILITIES:
Performs weekly audits of the charge aster to ensure charge accuracy and compliance with all pricing.
Performs routine audits of each hospital department's Posted Charges reports in order to maximize charge capture.
Facilitates development of strategies to improve reimbursement after identifying trends that negatively impact revenue capture.
Performs routine audits of each hospital department's Posted Charges reports in order to maximize charge capture and ensure correct reporting of medical services.
Performs weekly audits of the charge aster to ensure charge accuracy and compliance with all pricing.
Liaises with the Analyst - Clinical Billing Compliance and Systems & Contracts Specialist to implement changes in the charge aster and/or Contract Management that were identified during routine audits.
Analyzes coding and charging by Outpatient departments following billing guidelines for high riyal departments, i.e.; Emergency Room, Specialty Clinics, procedures performed within the clinics.
Actively seeks opportunities to positively impact Revenue Integrity workflows and metrics, utilizing experience to identify process improvement needs and to design and implement best practices.
Works with other departments, physician offices and the Training Specialist to adapt best practices to changing needs within the healthcare environment. Escalates issues to Manager when a department is not responsive to suggestions for preventing revenue loss.
Maintains an understanding of Sidra's Choice/No Choice policy and how it relates to patient liability and Contract Management rules within the Cerner system.
Provides analysis to support Sidra's service/procedure compliance programs.
Treats colleagues, patients, and visitors with dignity and respect at all times and promotes and maintains effective communication and teamwork
Adheres to Sidra's standards as they appear in the Code of Conduct and Conflict of Interest policies
Adheres to and promotes Sidra's Values
QUALIFICATIONS, EXPERIENCE AND SKILLS: ESSENTIAL PREFERRED
Education Bachelor's Degree in commerce, health information or relevant discipline. Master's Degree in commerce, health information or relevant discipline.
Experience 3+ years of experience in healthcare compliance, auditing, quality control, finance, and medical affairs. Extensive knowledge of medical devices or the pharmaceutical industry is highly relevant.
5 years of experience in a start-up environment.
Experience with Cerner.
Certification and Licensure Coding certification for hospital and/or physician.
Professional Membership
Job Specific Skills and Abilities
Requires knowledge of US Medicare regulations and NCCI Edits.
Timely completion of tasks.
Proficiency with Microsoft Office suite
Fluency in written and spoken English
Clinical knowledge combined with finance knowledge.
Fluency in written and spoken Arabic is preferred.
Sidra Medicine is a 400-bed women's and children's hospital, medical education and biomedical research center in Doha, Qatar. The hospital first opened its outpatient facility in 2016, followed by its inpatient hospital in January 2018. Qatar Foundation, a quasi-government organization, allotted a massive $7.9 billion budget for the hospital's construction. It first selected the center's contractors in 2008 but in 2014 assigned new contractors to complete the project. Biomedical research first began at Sidra in 2015. Outpatient care facilities and services were inaugurated in May 2016; as of 2018 there are at least 50 outpatient facilities. Throughout 2017, more than 25,000 people were treated at the hospital's outpatient clinic. On 14 January 2018, Sidra launched its inpatient hospital with 400 beds, treating 10 patients on its initial day of opening. The hospital is expected to become fully commissioned sometime in 2018, after the construction of an emergency department and the addition of further services. Roughly 3,900 staff members were retained by Sidra at the time of inaugurating its inpatient hospita
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