[Hiring] Charge Audit Specialist @UF Health

Role Description

The Charge Audit Specialist has responsibility to perform charge capture audits, initiate and lead performance improvement efforts to enhance charge capture, educate clinical departments and promote revenue cycle integrity.

• Perform charge capture audits by comparing the medical record documentation against the itemized bill.
• Identify charging, coding or clinical documentation issues and work with ancillary departments to resolve issues and notify appropriate leadership.
• Prepare modifications to patient charges as a result of the audits and as required to ensure appropriate revenue integrity.
• Respond to RAC and other third-party payer audit requests in collaboration with Health Information Management and Patient Financial Services.
• Maintain an audit activity report to track and communicate audit activity with the associated financial impact.
• Analyze audit results to identify patterns, trends, variances and opportunities to improve revenue integrity.
• Initiate and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance charge capture and promote revenue cycle integrity.
• Provide education to all clinical departments as needed to promote appropriate charge capture processes and improve understanding of the documentation requirements for specific charge activity.
• Function as a resource to the CDM Coordinator when clinical information is needed to appropriately maintain the Charge Description Master.
• Analyze and resolve patient claims being held by billing edits (i.e. NCCI/modifier 59, Medical necessity, Correct coding Initiative, Outpatient Code Editor (OCE), Inpatient Code Editor, Self-Administered and other claims requiring clinical expertise).
• Compare UB04 charges to BAR charges and ensure all discrepancies are appropriate.
• Perform all other duties as assigned by management within job scope.

Qualifications

• High School Diploma/Equivalent
• 2-years Medical Coding
• Preferences: 3-4 years of experience; charge audit or finance related experience. Experience in coding and/or reimbursement.
• Active coding certification from AAPC or AHIMA
• Preferences: Certified Professional Coder (CPC)
• Certified Professional Coder (CPC) required within 1 year of hire.