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. Every day, you will meticulously review clinical documentation, physician orders, and service records to identify all billable services, assign appropriate CPT, HCPCS, and ICD-10 codes, and ensure accurate charge entry. You will also collaborate with clinical departments, coders, and billing specialists to clarify documentation, resolve discrepancies, and educate on best practices, staying current with payer and regulatory changes. To be successful in this role, you will combine a strong medical terminology background, robust coding knowledge (CPT, HCPCS, ICD-10), and exceptional attention to detail. You will demonstrate a proactive approach to resolving charge capture issues, strong analytical and communication skills, and thrive in a fast-paced environment dedicated to financial accuracy and compliance. Conducts appropriate reviews using critical thinking skills to understand how to transfer payments. Reviews and posts payments and write-off/adjustments from insurance and patients. Reviews Explanation of Benefits (EOBs)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; applies knowledge of payer contracts and experience with insurance reviews to gather additional information as necessary. Posts and tracks electronic funds transfer (EFT) information and validates EFTs for accuracy. Follows write-off approval protocols for non-routine adjustments. Completes daily posting log and quarterly cash handling audits and reports findings to Supervisor. Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority or to escalate following established procedures. Notifies Supervisor/Manager of ongoing issues and concerns as appropriate. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. Meets quality assurance and productivity standards for timely and accurate posting of payments in accordance with organizational policies and procedures. Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements, compliance program, HIPAA, etc. Applies current knowledge of cash posting processes. Applies current knowledge of government/commercial insurance reimbursement terms, contractual and/or other adjustments and remittance advice details. Establishes and maintains professional and effective relationships with peers and other stakeholders. Establishes and maintains a professional relationship with clinics and FMG staff in order to resolve issues. Depending on role and Epic training, may be called upon to support other areas in the Revenue Cycle.
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED