[Hiring] Charge Capture Specialist @Prisma Health

Role Description

Serves as the charge capture subject matter expert responsible for charge capture analysis, workflow and maintenance of designated work queues. Resolves edits prior to billing. Evaluates and provides guidance related to billing and/or clearinghouse system edits.

• Works assigned Epic charge review and billing work queues to meet our compliant standardized min daytime frame, ensuring appropriate medical documentation exists to support charge capture compliance.
• Validates assigned principal diagnosis, all secondary diagnoses, principal procedures and all secondary procedures and CPT/HCPCs codes.
• Advises departmental revenue owners and their staff on proper usage of charge codes, identifies opportunities for capturing additional revenue in accordance with payer guidelines and develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
• Reviews and applies appropriate billing guidelines, state and federal regulations, and third-party billing rules/coverage.
• Completes internal charge review audits for assigned clinical departments to ensure that charges are generated in accordance with established policies and timeframes.
• Performs other duties as assigned.

Qualifications

• High School diploma or equivalent OR post-high school diploma/highest degree earned
• Three (3) years health care revenue cycle related experience

Requirements

• In lieu of the education and experience requirements noted above, an Associate degree may be considered.
• In lieu of the education and experience requirements noted above, a Health Science/Business/Coding Certificate and two (2) years of healthcare revenue cycle related experience may be considered.
• Certification in one of the following: RHIT, RHIA, CCS, CPC, CRCR, CRCA or CHFP preferred
• Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.

Work Shift

Day (United States of America)

Location

Patewood Outpt Ctr/Med Offices

Facility

7001 Corporate

Department

70019091 Revenue Integrity

Company Description

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.