Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below.
General Purpose of Job:The Charge Capture Specialist will report to the Manager of Revenue Integrity. Follows charge capture initiatives, processes, and procedures to ensure accurate and timely capture of all chargeable procedures. Review inquiries associated with HCPCS/CPT code assignment, modifiers, or any other component associated with charge capture that may impact the revenue cycle or data analytics. Work with the pre-bill edit team to take appropriate action to resolve charge capture/billing related issues and communicate to the revenue cycle departments when changes need to be made.
Essential Duties and Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
- Maintains utmost level of confidentiality at all times.
- Adheres to Driscoll System policies and procedures.
- Maintains a proper office atmosphere and works as a team player to help fulfill the Team job responsibilities while maintaining a positive team environment that is conducive to customer and employee satisfaction.
- Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
- Maintains composure, effectiveness, and flexibility under pressure.
- Determine the appropriateness of patient charges by verifying billing data for accuracy and completeness and by following regulatory requirements to resolve edits or exceptions.
- Apply modifiers when appropriate or make necessary adjustments to patient account charges and/or balances.
- Analyze accounts for specialized billing requirements that require a review of medical record documentation.
- Provide charge review results and develop and coordinate educational training for facility staff related to charging/billing issues.
- Review regulatory and compliance communications, applicable CMS transmittals and location coverage decisions and assess impact to revenue integrity procedures and implement changes as needed.
Education:- Associate degree or above OR a healthcare license/certification required
- Minimum of 3 years of directly related healthcare experience and strong coding familiarity required
- Knowledge of CPT/HCPCS codes or experience in charging or performing charge validation reviews preferred.
- Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT etc., can be accepted in lieu of degree with work experience.