Charge Capture Audit Analyst

2 weeks ago

Jupiter, United States Jupiter Medical Center Full time

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education: Associate Degree and/or completion of a relevant formal certification program. Certification/Licenses: Current CPhT, CPC, CCS, CCA, COC, CRC, RHIA and/or RHIT required or scheduled/obtained within six months of hire date. No Pharmacy Tech license required.
Experience / Qualifications: Minimum of one-year related work experience in outpatient and/or acute care hospital coding and/or Pharmacy preferred. Coding, Revenue Cycle, or hospital outpatient charge capture experience preferred. Comprehensive knowledge of hospital revenue cycle operations, hospital charge masters, as well as hospital department charge capture and charge reconciliation.
Knowledge of NDC numbers, Medicare billing units and correct coding principles of CPT/HCPCS, ICD-10 and modifier selection, as well as UB04 revenue codes. Comprehensive understanding of Federal, State and Local coding guidelines and payment methodologies. Must possess excellent analytical, organizational, verbal, and written communication skills and be professional in both appearance and approach. Ability to reliably work independently in a fast-paced environment and be accountable for accurate results. Must be proficient in MS Office, particularly Excel and Word, and be very detail oriented. Comprehensive understanding of auditing concepts preferred. Experience in Star, 3M, Cerner, One Content and/or other financial and EMR systems.

Position Summary:
The CCA Analyst - Pharmacy is responsible for the accuracy and efficiency of the daily Pharmacy and CCA technology functionality and workflow.
Responsible for charging and/or correcting facility Pharmacy charges for all inpatient, outpatient, observation, outpatient-in-a-bed, and Cancer Center patient types.
The CCA Analyst - Pharmacy is responsible for verifying proper documentation for Medicare medication waste and applying appropriate charge.
The CCA Analyst - Pharmacy is responsible for daily/weekly/monthly audits of Pharmacy medication charge on dispense and charge on administration carts.
The CCA Analyst - Pharmacy will work the Failed Claim Report, HL7Report, daily Pharmacy High Dollar report, and all billing edits daily to resolve edits and/or errors, make charge corrections, and/or add appropriate modifiers per CPT and CMS guidelines to assure appropriate and compliant revenue.
The CCA Analyst - Pharmacy will collaborate on inpatient, outpatient, ER, and series accounts with Health Information Management, clinical departments, and Patient Financial Services to resolve coding edits, billing errors, and support the CCA Analyst in implementing initiatives that will ensure accurate and efficient charge capture and charge reconciliation processes.
Collaborates with Pharmacy and/or Nursing when there is missing and/or inaccurate documentation for compliant charging to ensure timely charging.
Performs other duties as assigned.

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