Charge Review Specialist
ATLANTA DIABETES ASSOCIATES PC•Atlanta, KS
•Onsite
About The Position
As a Charge Review Specialist, you will review and analyze medical charges and claims to ensure accuracy, compliance, and adherence to billing guidelines. The role helps prevent billing errors, identify discrepancies, and optimize revenue for the healthcare organization. You will review medical documentation, verify coding and charges, work with coding and billing specialists to resolve issues, and follow up on outstanding claims.
Requirements
- High school diploma or equivalent.
- Proven experience in charge review, medical billing, or coding.
- Proficiency with electronic health record (EHR) systems, billing software, and coding tools.
- Strong knowledge of medical terminology, CPT, HCPCS, ICD-10 coding, and compliance regulations.
- Detail-oriented with exceptional analytical and problem-solving skills.
- Excellent communication and teamwork abilities.
- Familiarity with HIPAA regulations and patient confidentiality.
Nice To Haves
- Certification in medical coding.
Responsibilities
- Review and analyze medical documentation, including patient records, encounter forms, and electronic health records.
- Verify the accuracy of CPT, HCPCS, and ICD-10 codes assigned to services and procedures.
- Ensure charges submitted for billing are complete and meet documentation requirements.
- Assess coding compliance with federal and state regulations and payer-specific guidelines.
- Identify and rectify coding errors, discrepancies, and unbundling issues.
- Collaborate with coding specialists to resolve coding-related discrepancies.
- Validate that charges are appropriate for services rendered and match the medical records and patient-file documentation.
- Investigate undercoding or overcoding issues and take corrective action.
- Collaborate with billing specialists to ensure corrected charges are accurately resubmitted.
- Prepare and maintain documentation related to charge reviews and corrections.
- Monitor and resolve outstanding claims, communicate with payers, and reconcile payments.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
