Charge Entry Specialist, Business Office, Downtown Nashville

Heritage Medical Associates•Nashville, TN

4d•Onsite

About The Position

The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice. This role involves capturing and reviewing daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly. The specialist will utilize CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services, with potential for other specialties based on performance. Effective communication with providers and clinical staff is essential to obtain missing or incomplete information. The role also includes auditing imported encounters against the daily appointment schedule, reviewing and finalizing daily summary reports, preparing end-of-day batch documents for scanning, and reviewing encounter tracking reports to ensure timely accounting of all encounters. The specialist will alert the department supervisor of any issues needing further research and fulfill month-end requirements. Secondary responsibilities include maintaining strong knowledge of CMS policies and private-payer guidelines, utilizing the Correct Coding Initiative Edit List (CCI), informing the Patient Accounts Department of needed balance reviews, researching front-end claim rejections, and resolving discrepancies. The role requires utilizing various coding and billing references, consistently following internal protocols, and demonstrating a commitment to expanding knowledge through continuing education. A positive willingness to take on additional assignments and responsibilities, along with maintaining professional and courteous relationships and predictable attendance, is expected.

Requirements

High school diploma required
5+ years of Charge Entry or Medical Billing experience required
Must have knowledge of CPT and ICD10

Nice To Haves

Active Certified Coder License preferred (CPC, CCS)
OB/GYN Coding Experience Preferred
Multi-Specialty physician coding experience preferred
Completion of an accredited Medical Coding/Billing Program preferred
Experience with EPIC EMR System and Electronic Charge Capture preferred

Responsibilities

Captures and reviews daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly.
Utilizes CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services. Other specialties may be added based on performance level.
Communicates effectively and respectfully, both in verbal and written form, with providers or clinical staff to obtain missing or incomplete information.
Audits the imported encounters against the daily appointment schedule to ensure all encounters have been captured correctly.
Reviews and finalizes daily summary reports prior to close of day.
Prepares all end-of-day charge and payment batch documents for Scanning Department.
Reviews encounter tracking reports to ensure all encounters are accounted for in a timely manner.
Alerts department supervisor of any issues needing further research.
Fulfill month end requirements
Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines.
Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers.
Informs Patient Accounts Department when additional account balance reviews are needed.
Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies.
Utilizes various coding and billing references to resolve complex billing scenarios.
Consistently follows internal coding and billing protocols and policies.
Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year.
Demonstrates a positive willingness to take on additional assignments and responsibilities.
Must maintain professional and courteous relationships with all team members at all times.
Must have predictable and consistent attendance and follow all attendance policies.