Charge Entry Specialist, Business Office, Downtown Nashville

Heritage Medical Associates•Nashville, TN

17d•Onsite

About The Position

SUMMARY: 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. ESSENTIAL DUTIES AND 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. Accurately posts all payments paid at the time of service to the patient’s account. Audits and balances daily payment totals to Front Office Coordinator’s (FOC) daily deposit. 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. Secondary Responsibilities: 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.

Requirements

High school diploma required
2+ years of Charge Entry or Medical Billing experience required
Knowledge of CPT , ICD-10CM, HCPCS coding and Modifier usage
Knowledge of CMS billing and documentation guidelines and CCI Edit Lists
Excellent computer skills, including advanced typing speed, ten-key and mouse click selection skills
Ability to easily and quickly maneuver through various computer software programs such as MS Outlook, Word, Excel, electronic health records, patient billing systems, and other medical information software systems
Exceptional attention to detail and the ability to quickly identify discrepancies or uncommon billing situations
Strong judgment skills and ability to work through complex matters independently
Excellent time management and organizational skills
Ability to prioritize work responsibilities and complete assignments in a timely fashion
Strong initiative to anticipate departmental needs and work supportively with team members
Ability to work effectively and cooperatively with all levels of management, physicians, team colleagues, and other departments.
Must be able to sit for long periods of time
Requires moderate walking, bending, pushing, pulling, twisting and lifting
Mental alertness

Nice To Haves

CPC-A (Apprentice) is preferred, but not required
Completion of an Accredited Medical Coding/Billing Program preferred
ICD-10CM Training preferred
Experience with Electronic Medical Records 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.
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.
Accurately posts all payments paid at the time of service to the patient’s account.
Audits and balances daily payment totals to Front Office Coordinator’s (FOC) daily deposit.
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.