Charge Capture Processor

Default Work Shift:

Day (United States of America)

Hours:

0

Salary range:

$18.78 - $28.54

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Clinic Billing Services

Job Objective:

Responsible for the review, update or entry of charges to the EPIC PB/HB billing system. Updates are based on LCD, NCCI and MUE edits contained within the EPIC system to reduce denials and produce clean claims.

Job Description:

Education:
Required: High school diploma, GED or higher level degree
Preferred: Some college or degree

Licensure/Certification:
Preferred: Non APC coding certificate

Experience:
Required : One (1) year in a clinic or hospital environment
Preferred: Medical billing experience with extensive knowledge in Physician and clinical based billing

Reports To: Manager or Supervisor-Coding and Charge Capture
Supervises: N/A
Ages of Patients: N/A
Blood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to communicate with all levels of management and providers, Ability to prioritize work queues and work somewhat independently, Ability to review and interpret basic provider documentation to identify necessary additions, changes or voids, Detail oriented, Experience with Internet applications, MS Word and Excel, CMS and payer portals or websites, Knowledge of medical terminology, managed care, CPT/ICD10 coding and modifier association, Knowledge of Medicare and Commercial payer LCD’s and NCCI edits and resolution process, Positive interpersonal skills, Prior EPIC experience a plus, Research and analytical skills, Strong data entry and keyboarding skills, Ten key by touch and knowledge of all basic office equipment

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
2. Reviews assigned charge capture work queue daily including but not limited to: Filtering on priority based on high dollar and date of service, Matching E & M services to procedures, Validation of Bill area, Service provider and billing provider, Validation of New verses established patient, Validation of NDC numbers, proper quantity and administration code
3. Updates or validates date of injury as indicated.
4. Reviews documentation to ensure charge opportunities have not been missed.
5. Enters comment as indicated on each encounter touched.
6. Defers any encounter with a comment that requires coder or management review.
7. Updates insurance as indicated including running a current verification.
8. Maintains productivity standards per departmental policy.
9. Maintains encounter turnaround time to at or below three days .
10. Identifies and reports any system issues or provider trends affecting the charge capture process.
11. Attends coder continuing education and departmental meetings as instructed.
12. Enters and reconciles any manual batches as assigned.
13. Demonstrates team support by completing training in other positions and assisting as needed.
14. Performs other duties as assigned.