Role Description
As a Charge Capture Representative, you will be a central figure responsible for the accurate and timely capture of all billable services and procedures, directly impacting our revenue cycle and ensuring appropriate reimbursement. You will play a vital role in optimizing financial performance and maintaining billing compliance.
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Meticulously review clinical documentation, physician orders, and service records to identify all billable services.
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Assign appropriate CPT, HCPCS, and ICD-10 codes, and ensure accurate charge entry.
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Collaborate with clinical departments, coders, and billing specialists to clarify documentation and resolve discrepancies.
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Educate on best practices, staying current with payer and regulatory changes.
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Conduct appropriate reviews using critical thinking skills to understand how to transfer payments.
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Review and post payments and write-off/adjustments from insurance and patients.
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Review Explanation of Benefits (EOBs)/Electronic Remittance Advice (ERAs), payments, adjustments, and insurance contracts.
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Post and track electronic funds transfer (EFT) information and validate EFTs for accuracy.
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Follow write-off approval protocols for non-routine adjustments.
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Complete daily posting log and quarterly cash handling audits and report findings to Supervisor.
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Identify and research unusual, complex, or escalated issues as assigned.
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Document all activities and findings in accordance with established policies and procedures.
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Maintain current knowledge of internal, industry, and government regulations as applicable to assigned function.
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Establish and maintain professional and effective relationships with peers and other stakeholders.
Qualifications
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High School Graduate or High School GED, upon hire.
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1-3 years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities (preferred).
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Graduation from a post-high school program in medical billing or other business-related field is preferred.
Requirements
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Strong medical terminology background.
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Robust coding knowledge (CPT, HCPCS, ICD-10).
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Exceptional attention to detail.
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Proactive approach to resolving charge capture issues.
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Strong analytical and communication skills.
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Ability to thrive in a fast-paced environment dedicated to financial accuracy and compliance.