Charge Capture Analyst-PRNScheduled As Needed
Charge Capture Analyst-PRNScheduled As Needed
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Job Description
Job Summary :
This position will be responsible for the entering reviewing auditing and maintaining of the hospital charges charge documentation and charge capture processes for accuracy and completeness in addition to the ongoing communication of charges. This role is responsible for facilitating proper charge capture and charge audits. Standard billing policies and reimbursement principles clinical documentation practices and CPT/HCPCS and ICD10 CM coding using the hospitals electronic information systems and manual processes.Job Description
Essential Responsibilities
a. Knowledge of Medical Necessity guidelines such as LCDs (Local Coverage Determination) and NCDs (National Coverage Determination).
b. Knowledge of APC (Ambulatory Payment Classifications) edits require the review of NCCI (National Correct Coding Initiative) and MUE (Medially Unlikely Edits) requiring addition of payment modifiers to resolve the edit.
c. Ensures accurate and timely charge capture methodologies are in place and executed for the assigned work unitensuring they are consistent (in terms of standardization) across pertinent areas/facilities as appropriate; reconciles charges against source documents to ensure that charges have been captured completely and accurately.
d. Identifies researches and analyzes billing errors and/or omissions working with appropriate team members; ensures revisions/corrections are done and followed up with departments.
e. Claims Edit Monitoring and Resolution provides guidance and/or assistance in the correction and prevention of Claim Edits that prevent compliance timely and accurate transmittal of claims.
f. Works with management to identify trend and address root causes of denials; helps pinpoint strategies for reducing overpayments.
g. Maintains a thorough understanding of federal and state regulations as well as specific payer requirements and explanations of benefits to identify and report charge/billing issues and payer discrepancies.
h. Reviews all Observation accounts and captures infusions and injection charges.
i. Prepares reports and provides departmental summary information to the Revenue Cycle team which is responsible for ensuring that all charges on a systemwide basis are being captured charged and reimbursed appropriately and for overall compliance.
j. Assists interdepartmental teams in troubleshooting accounts that are being held due to charging/documentation discrepancies.
k. Facilitates communication with care providers regarding documentation opportunities and/or requirements.
l. Performs related duties as required.
Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the associate for this job. Duties responsibilities and activities may change at any time with or without notice.
Education
- High school diploma or equivalent required; Associate degree in coding/billing or a related discipline is desired.
- Must have three to five years experience working with hospital charges coding or billing.
Licenses or Certifications
- Certification in CCS CCSP COC CPC CRCR or specialty coding is desired.
Work Shift :
Day Shift (United States of America)Scheduled Weekly Hours :
0Required Experience:
IC
Employment Type
Part-Time
