Senior Charge Review Specialist

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

📋 Description

• Accurately process code assignments and necessary billing data elements for both paper and electronic claims prior to payment processing and revenue reporting.

• Review coding edits, provider documentation, charting, and submitted coding to ensure accuracy and compliance.

• Identify the correct sequencing of ICD-10, CPT, and HCPCS codes under the guidance of the Revenue Integrity Manager.

• Address coding inquiries from providers and staff while offering regulatory and coding-initiative guidance.

• Evaluate provider coding, provide support, and audit Charge Review Specialist claims for quality assurance purposes.

• Ensure claims are processed accurately and in a timely manner, adhering to company procedures and industry best practices.

• Uphold HIPAA confidentiality and comply with relevant regulations, standards, and company policies.

• Achieve daily productivity targets.

• Engage in Revenue Cycle Team activities, support colleagues, and strive for continuous improvement and cost efficiencies.

• Create, implement, and enhance charge-review policies and procedures.

• Manage phone inquiries from providers, clients, and patients effectively.

• Record communications and activities in billing notes.

• Contribute to organizational initiatives and undertake additional duties that align with the organization's vision, mission, and values.

⛳️ Requirements

• High school diploma or GED equivalent.

• Four years of experience in healthcare revenue or medical billing cycles, including coding.

• Required certification must be maintained as one of the following: Certified Coding Specialist (CCS) through AHIMA; Certified Coding Specialist–Physician (CCS-P) through AHIMA; Certified Professional Coder (CPC) through AAPC; Certified Professional Coder–Hospital (CPC-H) through AAPC.

• Comprehensive understanding of billing and coding policies and procedures.

• Familiarity with ICD-10, CPT, HCPCS, and modifiers.

• Proficient in filing and collecting insurance claims.

• Prior experience with electronic claim filing and practice management software.

• Competent in using Windows applications, including Word, Excel, PowerPoint, and Outlook.

• Skilled in typing and 10-key entry; possesses data-entry capabilities.

• Knowledgeable in healthcare billing, reimbursement processes, regulations, medical terminology, anatomy, and insurance workflows.

• Basic accounting skills with the ability to accurately audit patient accounts.

• Strong analytical, problem-solving, organizational, prioritization, and deadline-management abilities.

• Experience with EPIC PM/EMR is preferred but not mandatory.

• Exceptional verbal and written communication skills.

• Capable of working independently and proactively engaging with supervisors and colleagues.

• Demonstrates a strong work ethic and professionalism.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for career advancement and professional development.

• Supportive work environment that values teamwork and collaboration.