SUMMARY: The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
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Captures and reviews daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly.
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Utilizes CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services. Other specialties may be added based on performance level.
- Communicates effectively and respectfully, both in verbal and written form, with providers or clinical staff to obtain missing or incomplete information.
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Audits the imported encounters against the daily appointment schedule to ensure all encounters have been captured correctly.
- Reviews and finalizes daily summary reports prior to close of day.
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Prepares all end-of-day charge and payment batch documents for Scanning Department.
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Reviews encounter tracking reports to ensure all encounters are accounted for in a timely manner.
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Alerts department supervisor of any issues needing further research.
- Fulfill month end requirements
Secondary Responsibilities:
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Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines.
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Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers.
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Informs Patient Accounts Department when additional account balance reviews are needed.
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Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies.
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Utilizes various coding and billing references to resolve complex billing scenarios.
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Consistently follows internal coding and billing protocols and policies.
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Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year.
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Demonstrates a positive willingness to take on additional assignments and responsibilities.
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Must maintain professional and courteous relationships with all team members at all times.
- Must have predictable and consistent attendance and follow all attendance policies.
SUPERVISORY RESPONSIBILITIES
CERTIFICATES, LICENSES, AND REGISTRATIONS
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Advanced knowledge of CPT, ICD-10CM, HCPCS coding and of Modifier usage for multiple specialties
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Knowledge of CMS billing and documentation guidelines and CCI Edit Lists
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Advanced understanding of medical documentation requirements for E/M coding and office procedures
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Ability to abstract key information from the medical record to ensure accurate coding
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Effective communication skills, to explain guidelines to new employees in an easy to understand manner
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Excellent computer skills, including advanced typing speed, ten-key and mouse click selection skills
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Ability to easily and quickly maneuver through various computer software programs such as MS Outlook, Word, Excel, electronic health records, patient billing systems, and other medical information software systems
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Exceptional attention to detail and the ability to quickly identify discrepancies or uncommon billing situations
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Strong judgment skills and ability to work through complex matters independently
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Excellent time management and organizational skills
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Ability to prioritize work responsibilities and complete assignments in a timely fashion
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Strong initiative to anticipate departmental needs and work supportively to respond to such needs.
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Ability to work effectively and cooperatively with all levels of management, physicians, team colleagues, and other departments.
PHYSICAL DEMANDS
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Must be able to sit for long periods of time
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Requires moderate walking, bending, pushing, pulling, twisting and lifting
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Mental alertness
WORK ENVIRONMENT
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High volume, faced paced office environment with a strong commitment to timeliness and organization
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Office environment-limited exposure to communicable diseases.
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No exposure to blood-borne pathogens or contaminated body fluids
