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Charge Capture Analyst
2 months ago
Position Overview:
The Revenue Integrity Specialist is accountable for ensuring precise and thorough charge capture by examining medical record documentation related to clinical services and procedures, thereby safeguarding data integrity.
This role involves conducting charge reconciliation activities to maximize charge capture in compliance with Medicare, Medicaid, or other third-party payer regulations.
Classification systems utilized include ICD-9-CM, CPT, HCPCS, along with various specialized financial systems essential for charging, billing, and reimbursement analysis.
The Revenue Integrity Specialist serves as a valuable resource for coding, reimbursement, and departmental inquiries regarding charges, auditing, and the charge master.
Key Responsibilities:
- Extracts data from designated systems to facilitate audit functions, ensuring data validation through research of discrepancies and cross-referencing with other systems.
- Analyzes charge capture and reconciliation data, delivering monthly trending insights.
- Assists in identifying, reporting, analyzing, and resolving information system issues.
- Provides backup support for report analysis and account corrections, maintaining a collaborative relationship with the Charge Services Director to complete monthly reporting.
- Actively engages in team development, striving to meet departmental performance metrics and achieve organizational goals.
Qualifications:
- Bachelor's Degree in Business Administration or Healthcare Finance is required; a Master's Degree is preferred.
- A minimum of 5 years of experience in hospital and finance roles is essential.
- Strong quantitative and financial analysis capabilities; adept time management skills with the ability to prioritize tasks effectively.
- Proficient in Microsoft Office Suite applications.
- Experience in claims processing, database management, and statistical analysis is preferred.
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