How to Apply
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The Charge Capture Specialist conducts account audits and review medical records for the purpose of substantiating patient charges in an effort to assure charge accuracy for services provided. This position utilizes governmental and organizational reimbursement guidelines practices in order to improve the accuracy and efficiency of the charge capture phase of the revenue cycle. The incumbent will assist the management staff in preparation of all audit findings for presentation to the charging departments as is appropriate. This position uses clinical knowledge and billing and coding experience to compare the medical records documentation to the individual items billed. This position works closely with CDM Specialist, medical records, finance, patient accounting departments and Site Director¿s to follow-up and resolve charge capture issues.
ESSENTIAL FUNCTIONS PERFORMED:
1) Audits patient bills looking for missing charges by utilizing computerized algorithm support and by utilizing charging guidelines and policies/procedures in order to identify and correct inaccurate or missing charges on patient bills.
2) Makes recommends for process changes in order to support improvement in charge capture and to maintain revenue integrity.
3) Supports the development of education related to charging mechanisms, including utilization of proper charges and documentation requirements.
4) Monitors charge capture activities (i.e. late charges, transmission errors, billing rejects related to CDM coding) to resolve problems relating to the charge capture process
5) Coordinates with the charge master function in order to optimize revenue generation, may suggest the creation of new charges in order to assist in the maintenance of compliant charge master functions.
6) Generates reports on revenue opportunities and associated topics in order to make recommendations to leadership for charge master changes.
7) Utilizes clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and resolve health information and department based billing inconsistencies. Maintains current understanding of coding guidelines and information from third-party payors on claims filing and the adjudication process.
Minimum Qualifications (REQUIRED):
High school diploma or equivalent with two (2) years of experience in healthcare coding and/or billing or an associate¿s degree in Health Information (no experience required)
Coding certification (CCS, CCS-P, CPC-H or CPC) or RHIT certification
Experience in healthcare coding and/or billing
Experience in hospital billing
Experience with MedAssests CCA.net software
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other healthcare-related degree with hospital billing audit, CDM or coding experience
As an equal opportunity employer, St.Vincent Health and all its ministries comply with all applicable employment laws and regulations. In order to provide equal employment opportunities to all individuals, employment decisions at St. Vincent Health and all its ministries are based on merit, qualifications and abilities.
St. Vincent Health and its ministries do not discriminate based on race, color, religion, gender, disability, protected veteran status, sexual orientation, national origin, age or any other characteristic protected by law.
If you have additional questions about your application process, you may contact our HR Service Center at (317) 338-8640 or toll free at (877) 784-4772.
St. Vincent Health
- 2 years ago - save job