Professional Billing (PB) Senior Charge Management Coordinator

University of Virginia

16h•Onsite

About The Position

The Professional Billing (PB) Senior Charge Management Coordinator is a key member of the Revenue Integrity team ensuring accurate, compliant, and efficient professional billing by partnering closely with PB Coding, PB Billing, clinical departments, and IT. This role safeguards revenue through expert knowledge of Epic, strong analytical skills, and deep understanding of clinical workflows, documentation, and regulatory requirements.

Requirements

Bachelor’s degree required or relevant experience may be considered in lieu of Bachelor's degree.
A minimum of five years of experience required in a complex hospital setting
Knowledge of third party billing and reimbursement methodologies required
Understanding of CPT level II and III HCPCS and hospital charging methods is essential
General comprehension of medical terminology is necessary.

Responsibilities

Ensure all professional charges are accurately captured, routed, and posted.
Review Epic testing to confirm charges generate as expected; research and resolve discrepancies.
Monitor charge reconciliation, charge lag, and revenue leakage trends.
Support new service lines and workflow changes to maintain accurate charge capture.
Maintain in‑depth knowledge of Epic functionality, charge router logic, and clinical workflows.
Translate clinical and operational needs into Epic solutions that improve workflow and reduce compliance risk.
Participate in system testing, upgrades, and build validation for clinical and billing applications.
Provide ongoing Epic support to end users and identify opportunities for system optimization.
Partner with PB coders to resolve documentation gaps, coding questions, and charge discrepancies.
Review coding edits and denials; identify root causes and implement corrective actions.
Support coding accuracy through education, audit participation, and trend analysis.
Work with PB Billing, Administrators, Physicians and Coding Educators to resolve claim edits, rejections, and denials.
Validate claim accuracy for high‑risk or high‑dollar encounters.
Ensure compliance with payer rules, federal/state regulations, and internal policies.
Document current workflows and identify opportunities to maximize Epic functionality.
Apply established Epic policies and assess the impact of system changes.
Maintain knowledge of regulatory requirements (e.g., Medicare) and request system modifications as needed.
Provide cost‑effective, process‑efficient recommendations for system enhancements.
Coordinate with Coding Education on documentation, coding changes, and Epic functionality.
Provide support during go‑lives and workflow transitions.
Support the development of job aids, tip sheets, and communication materials.
Serve as a liaison between coding, billing, clinical teams, and IT.
Conduct internal audits of documentation, coding, and charge capture.
Validate accuracy in high‑risk specialties and ensure corrective actions are implemented.
Monitor compliance risks and support mitigation strategies.
Work with clinical leaders, IT, administrators, and revenue cycle teams to improve processes.
Participate in committees, workgroups, and revenue integrity initiatives.
Support leadership with data, analysis, and recommendations for financial improvement.