POSITION SUMMARY |
MINIMUM QUALIFICATIONS AND REQUIREMENTS
- The Pricer Specialist performs charge identification and charge entry on all assigned inpatient and outpatient accounts audited by the RMD. Request service codes for new items used from the Charge Master Department, compile worksheets from the Inpatient and Outpatient Charge Audit Analyst, and enter/remove charges identified for correct claim submission.Assigns accurate payment methodologies from contract matrix, based on payer reimbursement methodology, assuring correct and accurate reimbursement.
- Licenses and Certifications Required
- Educational Requirements
- High School Graduate required or Associates degree preferred.
- Experience Requirements
- Two-year minimum data entry experience in healthcare related field preferred. Experience with PCs, word processing, spreadsheet, graphics, and database software applications are desired.
- Special Skills or Training Requirements
- Strong quantitative and organization skills.
- Ability to understand insurance terms and contract language.
- Ability to understand medical records, hospital bills, and the charge master.
- Ability to understand all ancillary department functions for the facility.
- Knowledge of medical terminology, medical supplies, and two years experience in data entry both alpha and numeric.
- Ability to identify and enter all charge discrepancies on designated outpatient accounts.
- Assign accurate payment reimbursement on designated accounts.
- Request service code(s) from the charge master department for chargeable items without a service code.
- Ability to identify correct revenue codes for supplies, orthotics, prosthetics, implantable devices, pharmacy, and various service areas.
- Retrieve designated inpatient and outpatient medical records from HID for the Coder/Charge Audit Analyst.
- Ability to utilize and understand computer technology.
- Ability to communicate orally and in written form.
- Must be team oriented with strong interpersonal skills.