[Hiring] Charge Integrity Specialist @LCMC Health

Role Description

Under the direction of the Manager of Revenue Integrity, the Charge Integrity Specialist is responsible for reviewing and validating patient charges before billing to ensure accuracy and compliance with coding and billing regulations. The role involves working collaboratively to resolve discrepancies and improve the overall charge capture process by identifying trends and themes. The Charge Review Specialist ensures that all charges are accurately reflected in patient accounts and that any issues are promptly addressed. The position receives general oversight by the Charge Review Coordinator.

• Review patient charges to validate they are accurately entered and supported by clinical documentation.
• Ensure charges match the procedures and services provided, using appropriate charge capture standards.
• Assist in daily resolution of revenue integrity edits that prevent accounts from billing, by reviewing the medical record and applicable documentation.
• Identify and investigate discrepancies or missing charges in patient accounts with the intent to resolve.
• Report issues and participate in the resolution of any potential or actual revenue/charge related issues.
• Coordinate Charge Description Master (CDM) error findings with CDM team.
• Monitor EPIC Revenue Integrity Dashboard(s) and Ri assigned work queues to assist in completion and timeliness of completion meeting Revenue Integrity Department standards.
• Respond to departmental charging inquiries in a timely manner and document questions received to create repository.
• Provide support for assigned cost centers within service lines in collaboration with the charge integrity teammates.
• Work with Coding and other clinical departments to identify and resolve errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.
• Contribute and support quarterly improvement initiatives as directed by revenue integrity leadership.
• Serve as primary service line representative for all charge related inquiries and issues and proper usage of charge codes.
• Offer feedback on issues identified, and potential solutions, in the spirit of process improvement.
• Monitor and report charge capture trends and provide input on improvements that prevent revenue leakage.
• Perform quality work within deadlines and/or Key Performance Indicators (KPIs) with or without direct supervision.
• Interact professionally with coworkers and customers.
• Work effectively as a team contributor on all assignments.
• Work independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations.
• Deliver positive patient experience, where applicable.
• Complete and/or attend mandatory training and education sessions within approved organizational guidelines and timeframes.
• Perform other miscellaneous duties as assigned.

Qualifications

• Required: 2 years' experience in a hospital setting, revenue cycle, healthcare industry or coding.
• Preferred: EPIC HB/PB experience.

Requirements

• Minimum: High school diploma or GED with equivalent combination of certification and experience is required.
• Preferred: Associate’s degree in healthcare administration, Health Information or related field.
• Certification: Applicable professional certification through AHIMA (CCA) or AAPC (CPC‑A, COC-A) are highly desirable. Must obtain professional credential within 6 months of employment or Epic Certified.

Skills and Abilities

• Interpersonal and communication skills.
• Analytic and organizational skills.
• Critical thinking and the ability to meet deadlines.
• Computer skills; MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet.

Work Shift

Days (United States of America)

Company Description

LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary.

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems – it’s all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do.
• You are welcome here.