Senior Charge Capture Analyst

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Provide guidance to departmental revenue owners and staff on the appropriate use of charge codes through medical record analysis.

• Evaluate and implement billing guidelines, as well as state and federal regulations, along with third-party billing rules and coverage.

• Recognize opportunities to enhance revenue capture in line with applicable guidelines.

• Oversee daily charge capture, revenue reconciliation, trending of late charges, revenue trends, and work queues.

• Identify operational patterns and benchmarks.

• Collaborate with Revenue Cycle and IT personnel to address accounts that are not processing through the HB Revenue Cycle system.

• Confirm principal and secondary diagnoses, procedures, and CPT/HCPCS codes.

• Establish data requirements and partner with analytics teams on internal charge review audits.

• Support the supervisor with inquiries related to coding and billing, escalated accounts, and other issues.

• Engage in system conversions, implementations, upgrades, Epic go-live charging hub activities, and the Revenue Management Task Force.

• Conduct coding and reimbursement revenue reviews for proposed system builds.

• Collaborate with CDM, clinical departments, and I/S to assist in Epic and system builds for charge entry and capture.

• Diagnose and resolve charge issues and seek enhancement opportunities.

• Streamline processes to ensure services are reported accurately and reimbursed while ensuring compliance.

• Assess departmental charge capture procedures and revise documented protocols as necessary.

• Coordinate with department leadership, the CDM team, and stakeholders on new procedures, charge setup, and training initiatives.

• Work alongside vendors on optimization projects, which include data reviews, auditing, and testing.

• Carry out additional tasks as assigned.

⛳️ Requirements

• High School diploma or equivalent, or a post-high school diploma/highest degree attained.

• A minimum of five (5) years of experience in healthcare revenue cycle management.

• Alternatively, an Associate degree with four (4) years of healthcare revenue cycle experience, which includes two (2) years in charge description master/revenue integrity.

• Alternatively, a Bachelor's Degree with two (2) years of charge description master/revenue integrity experience.

• Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS.

• Knowledge of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, and revenue cycle processes.

• Ability to engage with diverse groups across all organizational levels by offering guidance and education.

• Capability to comprehend and apply National and Local Coverage Determinations to complete assigned work queues and routinely educate facility departments.

🏝️ Benefits

• Full-time employment.

• Day shift schedule.

• Remote work opportunity as indicated in the job title.