Charge Capture Specialist

This position is responsible for timely, accurate charge capture entry for the assigned Service Line/unit into the billing database for analysis. Information is obtained through chart review and assessment of documentation for appropriate charges within regulatory compliance. The coordinator will also be responsible for auditing charges for omissions and accuracy. The goal is to take advantage of all opportunities for patient reimbursement as documented in the patient record in a cost-effective manner while complying with federal/state and APC guidelines.

Emergency Dept:

The Charge Capture Specialist provides organizational duties and support for employees who perform Charge Capture for the Emergency Department. The specialist performs monthly audits of CCC staff and manages frequent complex interactions with many internal and external contacts as required for compliance, audits and accuracy. This role interacts with Charge Capture Supervisor, Director of Revenue & Reimbursement, Manager Charge Master, internal audit representatives, client relations, nurse auditors, corporate compliance officer, HIMs and billing coders, ED physician group, Lynx representatives, & IT staff. Under the direction of the Charge Capture Supervisor, performs account reviews and investigations, HBOC late charge entry, cross report facility reconciliations, daily charge capture audit (CCA) exceptions and meeting minutes. Assists the supervisor in updated information and education on an on-going basis to nursing and Charge Capture Coordinator staff.

Infusion Center:

The Charge Capture Specialist provides organizational duties and support for employees who perform Charge Capture for the Oncology Service Line. The specialist performs monthly audits service line staff and manages frequent complex interactions with many internal and external contacts as required for compliance, audits and accuracy. This role interacts with Patient Financial Services, Revenue Integrity, internal audit representatives, nurse auditors, corporate compliance officer, HIMs and billing coders oncology physician groups. Under the direction of the Service Line Operations Manager, performs account reviews and investigations, EPIC late charge entry, cross report facility reconciliations, and daily charge capture audit (CCA) exceptions. Assists the manager in communicating updated information and education on an on-going basis to nursing and oncology staff., Sedentary Work - Duties performed mostly while sitting; walking and standing at times. Occasionally lift or carry up to 10 lbs. Uses hands and fingers. - (Physical Requirements-United States of America)

High School degree

Minimum five (5) years experience related experience.

Advanced understanding of the Lynx client coding guideline algorithms, HBOC late charge entry, charge capture audit application, the CMS coding and billing regulations, outpatient prospective payment system (OPPS) for charging patients for ED services.

Experience performing charge capture audits.

Customer service experience with strong administrative skills including developing and improving office systems and procedures.

Demonstrated intermediate-level computer skills in MS outlook, word, power point and excel.

Strong oral, written and interpersonal communication skills including patient/customer relations experience.

Experience working with electronic medical records required.

Knowledge of healthcare regulatory compliance HIMS, HIPAA and coding rules, and an ability to maintain confidential and complex medical records information and to prepare accurate reports.

Ability to exercise judgment, courtesy, and tact in receiving callers, in giving and obtaining information and in making proper disposition of problems.

Ability to acquire considerable knowledge of governing policies and regulations, as well as the operational structure of the hospital.