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Charge Capture Analyst
Prisma Health
full-time
Posted on:
Location Type: Remote
Location: Remote • South Carolina • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Interacts with departmental revenue owners to monitor charge capture, revenue reconciliation and revenue trending across Prisma Health
- Completes focused charge review audits for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes
- 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
- Assist with monthly, quarterly, and yearly Charge capture revenue reconciliation auditing, reporting and education
- Partners with vendors for optimization projects to complete data review, auditing, and testing
- Performs other duties as assigned
Requirements
- High School diploma or equivalent OR post-high school diploma/highest degree earned
- Three (3) years of Health care revenue cycle related experience
- Associate degree (as alternative)
- Health Science/Business/Coding Certificate and two (2) years healthcare revenue cycle related experience (alternative)
- Job Related Certification in one of the following: RHIT, RHIA, CCS, CPC, CRCA/CRCR, or CBCS preferred
- Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes
- Ability to understand and apply National and Local Coverage Determination
Benefits
- Inspire health. Serve with compassion. Be the difference.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
charge capturerevenue reconciliationbilling guidelinesICD10 codingHCPCS codingCPT codingdata reviewauditingmedical documentationrevenue cycle processes
Soft skills
communicationadvisoryorganizationalcollaborationproblem-solving
Certifications
RHITRHIACCSCPCCRCACRCRCBCS
