Charge Capture Representative

Allina Health System • Saint Paul, MN

5d • $23 - $31 • Remote

About The Position

Allina Health is a not-for-profit health system that cares for individuals, families and communities throughout Minnesota and western Wisconsin. If you value putting patients first, consider a career at Allina Health. Our mission is to provide exceptional care as we prevent illness, restore health and provide comfort to all who entrust us with their care. This includes you and your loved ones. We are committed to providing whole person care, investing in your well-being, and enriching your career. Key Position Details: 1.0 FTE (80 hours per 2-week pay period) 8-hour day shifts No weekends Epic experience Fully remote Job Description: Responsible for reviewing clinical documentation and accurately assessing and entering charges for Emergency, Outpatient, and Observation services. Using medical software to correctly capture all billable charges. Identifies inconsistencies in medical reports and works with leadership and operations staff to improve charge capture and error correction and assists in analyzing related billing errors and omissions.

Requirements

• Must be 18 years of age with education and/or experience needed to meet required functional competencies as listed on the job description
• 2 to 5 years of experience working in health care insurance, billing, and charging

Nice To Haves

• High school diploma or GED
• Associate's or Vocational degree in business, healthcare, or related field
• 2 to 5 years of medical terminology experience
• Certified Coding Specialist - American Health Information Management Association (AHIMA) preferred upon hire

Responsibilities

• Ensures charges captured in an appropriate and timely manner.
• Reviews, calculates, and enters charges in the electronic medical record (EMR).
• Examines financial reports for accuracy edits.
• Processes and completes charge entry.
• Monitors and audits charts.
• Ensures charges are compliant with federal regulations.
• Strong partnership with a variety of departments that may include coding, finance, providers, site leadership etc. to assist with provider productivity and usage of dummy codes audits.
• Problem solves to identify missing notes and charges working directly with providers until the missing item(s) are completed.
• Identifies, analyzes, and edits charge capture errors.
• Identifies and investigates double charging, errors, and omissions and edits charges prior to data entry.
• Reconciliation of inpatient and outpatient hospital professional fees to identify missing charges and/or notes.
• Manages 3050WQ to ensure correct code, appropriate revenue department and Place of are accurate for all EM182 dummy codes.
• Management of Charge Review, Claim Edit, Account and Follow Up WQs.
• Verifies insurance eligibility and completes automated insurance eligibility verification, when applicable and appropriately documents information in Epic.
• Problem solves to identify and submit resolution to patient/client problems or issues, direct calls to appropriate department for resolution.
• Adjust accounts within guidelines.
• Updates patient demographic and insurance information.
• Registers patients as needed for billing for places of service outside of Allina.
• Follows-up regarding billing and quality of care issues, complaints/concerns.
• Document all contacts as directed by policy and where appropriate involving of care concerns/complaints.
• Maintains current knowledge on Patient Bill of Rights and problem solving.
• Refers quality of care complaints to appropriate department within Allina.
• Recommends account resolutions.
• Works with Revenue Cycle Management, clinic/hospital sites and providers throughout Allina to obtain referrals and prior authorizations for encounters that have been denied by the payers.
• Reviews and resolve accounts that are complex and require a higher degree of expertise and critical thinking.
• Identifies workflow problems.
• Works directly with providers and site leadership to address workflow issues and discuss opportunities for education to ensure providers have the tools necessary
• Informs manager about deficits in documentation for revenue efficiency and accuracy.
• Other duties as assigned.

Benefits

• Medical/Dental
• PTO/Time Away
• Retirement Savings Plans
• Life Insurance
• Short-term/Long-term Disability
• Voluntary Benefits (vision, legal, critical illness)
• Tuition Reimbursement or Continuing Medical Education as applicable
• Student Loan Support Benefits to navigate the Federal Public Service Loan Forgiveness Program

What This Job Offers

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