Description:
The Charge Review / Charge Entry Specialist is responsible for accurately reviewing and entering patient charges into the billing system to support timely, compliant claim submission and optimal reimbursement. This role validates charge documentation, applies correct codes and charge rules per client and payer requirements, and resolves discrepancies by coordinating with clinical and billing teams.
Responsibilities:
- Review all supporting documentation to confirm all billable services are captured.
- Enter charges into the practice management (PM) and/or electronic health record (EHR) system accurately and within required turnaround times.
- Validate required billing elements (date of service, rendering/provider, location, diagnosis pointers, units, modifiers, NDC/lot where applicable) prior to claim submission.
- Identify, research, and correct charge discrepancies such as missing charges, duplicate charges, incorrect units, invalid modifiers, or mismatched diagnosis-to-procedure linkage.
- Apply client-specific charge rules, fee schedules, and payer billing guidelines; escalate unusual scenarios or compliance concerns appropriately.
- Work charge edits, hold queues, and worklists; document actions taken and maintain clear audit trails in the system.
- Communicate with providers, staff, and internal teams to obtain missing information and resolve documentation issues.
- Support claim quality by reducing downstream rework, denials, and payment delays through proactive charge accuracy checks.
- Maintain productivity and quality standards.
- Participate in training, and follow HIPAA and company policies for PHI.
- Assist with periodic audits, reconciliation, and reporting
- Perform all other functionally related duties and special projects as assigned and needed.
Qualifications:
- High school diploma or equivalent required; associate degree in healthcare administration, business, or related field favorable.
- 1+ year of experience required in healthcare billing, charge entry, charge capture, or revenue cycle operations (clinic, hospital, or medical billing company environment).
- Working knowledge of medical terminology and basic reimbursement concepts.
- Familiarity with CPT, HCPCS, ICD-10-CM, modifiers, units, and common claim form requirements as applicable to the client specialty.
- Experience using PM/EHR systems and Microsoft Office (Excel, Outlook, Teams); ability to learn new client systems quickly.
- Strong attention to detail with a high level of accuracy and the ability to meet daily productivity and quality metrics.
- Ability to research issues, follow written procedures, and document work clearly.
- Strong communication and customer service skills for interacting with internal teams and external providers.
- Demonstrated commitment to confidentiality and compliance (HIPAA) and adherence to standard policies and procedures.
Preferred Qualifications:
- Experience with multi-specialty billing and high-volume charge entry workflows.
- Prior experience working with charge reconciliation, charge lag reporting, or charge capture audits.
- Knowledge of payer-specific billing rules (e.g., Medicare, Medicaid, commercial) and authorization/referral impacts on billing.
Pay: $17.00 - $20.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Retirement plan
- Vision insurance
Application Question(s):
- What PM system do you have experience working with (please list all)?
- What specialties do you have experience with (i.e. ortho, cardio, behavioral health, anesthesia, etc.) (Please list)?
- This position is a fully remote position working from home. The company will provide laptop, monitor, power cords and cables required to perform the job. Selected candidate will be required to have a safe and secure designated work space and provide their own secure Wi-Fi that meets 20 Mbps). Do you acknowledge these requirements?
- The pay range for this position will be $17 - 20/hr. and any forthcoming offer will fall within that range and commensurate with education, certification, experience. Do you acknowledge that this range is acceptable and your requirements align to that range?
Experience:
- Charge Review/Entry: 1 year (Required)
Work Location: Remote
