Charge Entry Specialist, Business Office, Downtown Nashville

Charge Entry Specialist, Business Office, Downtown Nashville Heritage Medical Associates - 3.5 Nashville, TN Job Details Full-time 1 day ago Qualifications High school diploma or

GED Full Job Description 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

Captures and reviews daily charges from the Electronic Health Record's Charge Passing System to ensure standard coding and billing guidelines are followed correctly. 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. 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. Prepares all end-of-day charge and payment batch documents for Scanning Department. Reviews encounter tracking reports to ensure all encounters are accounted for in a timely manner. Alerts department supervisor of any issues needing further research. Fulfill month end requirements

Secondary Responsibilities:

Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines. Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers. Informs Patient Accounts Department when additional account balance reviews are needed. Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies. Utilizes various coding and billing references to resolve complex billing scenarios. Consistently follows internal coding and billing protocols and policies. Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year. Demonstrates a positive willingness to take on additional assignments and responsibilities. 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

None

CERTIFICATES, LICENSES, AND REGISTRATIONS

Active Certified Coder License preferred (CPC, CCS) EDUCATION and/or

EXPERIENCE

High school diploma required OB/GYN Coding Experience Preferred 5+ years of Charge Entry or Medical Billing experience required Multi-Specialty physician coding experience preferred Completion of an accredited Medical Coding/Billing Program preferred Must have knowledge of CPT and ICD10 Experience with

EPIC EMR

System and Electronic Charge Capture preferred

KNOWLEDGE, SKILLS, AND ABILITIES

Advanced knowledge of

CPT, ICD-10CM, HCPCS

coding and of Modifier usage for multiple specialties Knowledge of CMS billing and documentation guidelines and CCI Edit Lists Advanced understanding of medical documentation requirements for E/M coding and office procedures Ability to abstract key information from the medical record to ensure accurate coding Effective communication skills, to explain guidelines to new employees in an easy to understand manner Excellent computer skills, including advanced typing speed, ten-key and mouse click selection skills 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 Exceptional attention to detail and the ability to quickly identify discrepancies or uncommon billing situations Strong judgment skills and ability to work through complex matters independently Excellent time management and organizational skills Ability to prioritize work responsibilities and complete assignments in a timely fashion Strong initiative to anticipate departmental needs and work supportively to respond to such needs. Ability to work effectively and cooperatively with all levels of management, physicians, team colleagues, and other departments.

PHYSICAL DEMANDS

Must be able to sit for long periods of time Requires moderate walking, bending, pushing, pulling, twisting and lifting Mental alertness

WORK ENVIRONMENT

High volume, faced paced office environment with a strong commitment to timeliness and organization Office environment-limited exposure to communicable diseases. No exposure to blood-borne pathogens or contaminated body fluids