Charge Capture Specialist 2

5000 Wellstar Medical Group, LLC•Atlanta, GA

About The Position

The Charge Capture Specialist II reviews clinical documentation to ensure timely, accurate, and compliant charge capture. The role works closely with Physician Practices as an educational resource on applicable government, state, and payer regulations and requirements. It also collaborates with cross-campus counterparts and Physician Practices to promote consistent, complete documentation and maintain backup coverage for charge capture in high-risk areas. Duties include charge entry, validating coding in Charge Review, educating charging departments, and reducing payer coding denials. The specialist reviews physician and nursing documentation, identifies overcharges and undercharges, evaluates medical necessity, and works with departments to improve charging and documentation procedures. The role supports new services and technologies by researching charge and coding requirements, identifies charging opportunities, and develops training on charge-review changes. It also contributes to revenue-cycle goals, process improvement, privacy compliance, cross-training, professional communication, and department operations.

Requirements

High school diploma or equivalent from an accredited institution required; bachelor's degree preferred.
One of the following certifications required upon hire: Certified Coding Associate, Certified Coding Specialist–Physician Based, Certified Outpatient Coder, or Certified Professional Coder.
Minimum two years of collection experience or minimum two years of physician billing experience.
Ability to perform mathematical calculations and keyboard by touch.
Basic knowledge of medical terminology and basic experience and knowledge of PC applications.
Excellent communication skills, including oral and written comprehension and expression, when interacting with patients, families, the public, coworkers, and professional offices.
Detail-oriented, organized, and self-directed, with the ability to learn quickly and meet continuous timelines.
Strong time-management skills and ability to manage multiple priorities and a heavy workload in a high-stress environment.
Flexibility to perform other tasks as needed in an active work environment with changing work needs.
Strong problem-solving, analytical, and investigative skills.
Excellent internal and external customer-service skills.
Ability and willingness to demonstrate service-oriented behaviors and maintain competency required for the job title and assigned unit or area.
Ability and willingness to demonstrate behaviors consistent with organizational values and performance-improvement standards.

Nice To Haves

Bachelor's degree.
For positions in Radiation Oncology, a ROCC credential through AMAC may be considered 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, including medical necessity.
Review clinical records to identify overcharges, undercharges, or charges requiring additional documentation.
Analyze and verify charging and documentation procedures and work with departments to modify them in high-risk areas, such as infusion services.
Develop and implement training for Physician Practices on changes, updates, and additions to charge review.
Identify and analyze new charging opportunities with assigned departments.
Research charge and coding requirements for new services and technologies.
Meet productivity and quality standards for accurate, timely charge capture in high-risk areas, along with assigned benchmarks, targets, and reporting requirements.
Contribute to the department's accounts receivable goal and identify system and process improvement opportunities for management.
Use assigned systems and processes proficiently, comply with HIPAA and other health system policies, and become cross-trained to cover 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, coworkers, management, clinical staff, and internal customers.
Share information about changes and procedures with peers and communicate through telephone, email, and other devices as appropriate.
Follow department procedures and regulatory requirements; use assigned office equipment, computer hardware, and hospital mainframe pathways; report software or hardware problems to a supervisor.
Participate in testing assigned software applications, including verification of field integrity.
Perform other duties as assigned.