Charge Capture Specialist Exempt

Hollywood Presbyterian•Los Angeles, CA

About The Position

The primary job duties this position is responsible for achieving are listed in order of importance. Review and analyze clinical documentation to identify and capture all billable services and procedures. Utilize coding systems (CPT, ICD-10, HCPCS, NRV's/ Revenue Codes) to assign appropriate codes for services rendered. Verify insurance eligibility and coverage to ensure proper billing and reimbursement. Monitor and resolve any discrepancies or issues related to charge capture and billing processes. Work closely with the billing department to ensure timely submission of claims and follow up on outstanding accounts. Maintain up-to-date knowledge of relevant regulations, billing practices, and payer requirements. Provide training and support to clinical staff on charge capture best practices and documentation standards. Assist in conducting audits and reviews to ensure compliance with internal policies and external regulations. Performs various functions related to revenue cycle operations. Reviews, analyzes and coordinates charge capture activities, including, but not limited to charge reconciliation, charge posting, evaluation/resolution of billing edits, department outreach and AD HOC reporting. Performs other job related duties as assigned.

Requirements

High School Education/GED
Insurance verification and knowledge of Medi-Cal, PPO, EPO, HMO, Medicare
Proficient in Microsoft Word/Excel/PowerPoint
Candidate should possess excellent written/verbal communication skills in addition to the ability to work with minimal supervision
Fluent in CPT/HCPCS, NRV/ REV Code terminology
Current Los Angeles County Fire Card (or must be obtained within 30 days of employment)
Assault Response Competency (ARC) required (within 30 days of hire)

Nice To Haves

Associates/Bachelor’s Degree in Healthcare Administration, Business Administration or related field preferred
Proven experience in charge capture, medical billing, or a similar role within a hospital setting 3-5 years' experience.
Strong knowledge of medical terminology, coding guidelines, NCCI edits, and billing regulations.
Proficient in using electronic health record (EHR) systems and billing software.
Excellent analytical skills with a keen attention to detail.
Strong communication and interpersonal skills, with the ability to work collaboratively with clinical and administrative staff.
Ability to prioritize tasks and manage time effectively in a fast-paced environment.
Excellent verbal/written communication skills

Responsibilities

Review and analyze clinical documentation to identify and capture all billable services and procedures.
Utilize coding systems (CPT, ICD-10, HCPCS, NRV's/ Revenue Codes) to assign appropriate codes for services rendered.
Verify insurance eligibility and coverage to ensure proper billing and reimbursement.
Monitor and resolve any discrepancies or issues related to charge capture and billing processes.
Work closely with the billing department to ensure timely submission of claims and follow up on outstanding accounts.
Maintain up-to-date knowledge of relevant regulations, billing practices, and payer requirements.
Provide training and support to clinical staff on charge capture best practices and documentation standards.
Assist in conducting audits and reviews to ensure compliance with internal policies and external regulations.
Performs various functions related to revenue cycle operations. Reviews, analyzes and coordinates charge capture activities, including, but not limited to charge reconciliation, charge posting, evaluation/resolution of billing edits, department outreach and AD HOC reporting.
Performs other job related duties as assigned.