Charge Capture Specialist 2

Wellstar Health System•VIRTUAL-GA, GA

About The Position

The Charge Capture Specialist II reviews clinical documentation to ensure timely, accurate, and compliant charge capture. The role works with Physician Practices as an educational resource on government, state, and payer regulations related to charges, and collaborates with cross-campus counterparts and Physician Practices to support consistent, complete documentation in high-risk areas. Cross-training and backup coverage help maintain seamless charge capture. Duties include charge entry, verifying coding in Charge Review, educating charging departments, and reducing payer coding denials. The specialist assesses physician and nursing documentation, identifies overcharges and undercharges, evaluates medical necessity, analyzes charging procedures, and researches charge and coding requirements for new services and technologies. The role also supports productivity and quality standards, contributes to department revenue-cycle goals, and identifies process improvements. The position requires professional communication with patients, families, payers, physicians, clinical staff, and internal departments; safeguarding patient privacy; following organizational and regulatory procedures; and using assigned computer systems, equipment, and software. Other duties may be assigned.

Requirements

High school diploma or equivalent from an accredited institution.
At least 2 years of collections experience or at least 2 years of physician billing experience.
Required coding certification: Certified Coding Associate, Certified Coding Specialist—Physician Based, Certified Outpatient Coder, or Certified Professional Coder.
Ability to perform mathematical calculations and keyboard by touch.
Basic knowledge of medical terminology and basic experience with and knowledge of PC applications.
Excellent communication skills, including oral and written comprehension and expression, when working with patients, families, the public, coworkers, and professional offices.
Detail-oriented, organized, and able to work independently.
Ability to learn quickly, meet ongoing timelines, manage multiple priorities and a heavy workload in a high-stress environment, and adapt to changing work needs.
Strong time-management, problem-solving, analytical, and investigative skills.
Excellent internal and external customer-service skills.
Ability and willingness to demonstrate excellent-service behaviors and maintain required competency for the job title and assigned unit or area.
Ability and willingness to demonstrate behaviors aligned with performance-improvement standards and organizational values, including efficiency and financial responsibility, safety, partnership and service, teamwork, compassion, integrity, trust, and respect.

Nice To Haves

Bachelor’s degree preferred.
ROCC credential through AMAC may be considered for Radiation Oncology positions in lieu of an AAPC or AHIMA credential.

Responsibilities

Ensure charging and documentation are accurate and complete across departments and campuses.
Assess physician and nursing documentation to confirm support for selected charge codes and medical necessity.
Review clinical records on an ongoing basis to identify overcharges, undercharges, and charges requiring additional documentation.
Analyze and work with departments to modify charging and documentation procedures in high-risk areas, such as infusion services.
Develop and deliver training to Physician Practices on charge-review changes, updates, and additions.
Identify new charging opportunities with assigned departments.
Research and analyze charge and coding requirements for new services and technologies.
Meet applicable productivity, quality, benchmark, target, and reporting standards for accurate charge capture.
Contribute to the team’s department accounts-receivable goal and identify system or process improvements for management.
Demonstrate proficient use of systems and processes, maintain HIPAA privacy compliance, and follow organizational, departmental, and emergency-preparedness procedures.
Become cross-trained and provide backup coverage for other staff as assigned.
Protect patient privacy and confidentiality, and ensure minors have a parent or guardian listed as guarantor when appropriate.
Communicate professionally with patients, families, payers, physicians, physician staff, coworkers, management, clinical staff, referral agencies, and internal customers.
Share relevant procedure changes with peers and relay information appropriately by telephone, email, and other communication devices.
Follow department procedures for breaks, time off, and shift assignments.
Operate office equipment and use ergonomic workstations, equipment, and supplies.
Follow Joint Commission (JCAHO) and other regulatory requirements.
Use assigned hospital mainframe menus and pathways and report software or hardware problems to the appropriate supervisor.
Participate in testing assigned software applications, including verification of field integrity.
Perform other duties and responsibilities as assigned and comply with Wellstar policies, standards of work, and code of conduct.