Charge Capture Analyst, FT, Days

Prisma Health • Greenville, SC

1d • Onsite

About The Position

Inspire health. Serve with compassion. Be the difference.
Job Summary
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.

Requirements

• High School diploma or equivalent OR post-high school diploma/highest degree earned
• Three (3) years of Health care revenue cycle related experience
• Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
• Ability to understand and apply National and Local Coverage Determination to complete assigned work queues and educate facility departments routinely.

Nice To Haves

• Associate degree
• Health Science/Business/Coding Certificate and two (2) years healthcare revenue cycle related experience
• Job Related Certification in one of the following: RHIT, RHIA, CCS, CPC, CRCA/CRCR, or CBCS preferred.

Responsibilities

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED