The Senior Charge Capture Specialist is responsible for performing chart audits to ensure coding compliance and accuracy, timely charge posting, and support of the team's operational functions.

Primary Duties & Responsibilities:

• Review charges to ensure proper procedure codes (CPT), modifiers, drug and supply codes (HCPCS), drug units, National Drug Codes (NDC), and diagnosis codes (ICD-10) are accurate based on the medical documentation in the patient record.

• Resolve edits in the practice management systems to ensure accurate billing.

• Request clarification on any mismatches to ensure accurate billing.

• Resolve edits in the practice management systems to ensure accurate billing.

• Post charges received electronically in the electronic medical record (EMR) in the practice management system in accordance with correct coding guidelines.

• Enter and post charges received manually in the practice management system accordance with correct coding guidelines.

• Review encounter tracking to ensure all services rendered are billed

• Work with team members to help them achieve quality and productivity standards.

• Research complex coding scenarios and provide feedback to coders.

• Assist with internal audits to ensure coders are posting charges in accordance with correct coding guidelines.

• Assist with work assignments for team members by engaging coverage for absent coders and covering assignments when necessary.

• Investigate and determine the root cause of claim denials to help improve the coding team’s accuracy with correct coding guidelines.

• Understand the rules engine in the practice management system and recommend rules that will help reduce errors in coding that cause claim denials.

• Effectively communicates with site managers to obtain all necessary information for billing.

• Effectively communicates with physicians to resolve billing issues.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.

Qualifications:

• Minimum High School Diploma or GED required.

• Minimum of five (5) years Medical Billing and insurance claim filing experience.

• Certified Coding Certification.

• Familiarity with medical billing software.

Knowledge, Competencies & Skills:

• Proficient knowledge of Medical Terminology, ICD, and CPT Codes.

• Accurate and efficient data entry skills.

• Demonstrated ability to work independently and as an effective healthcare team member.

• Proven organizational skills and ability to prioritize effectively.

• Excellent customer service skills.

• Strong written and verbal communication skills.

• Proficient computer software and database skills, including Microsoft Excel and Word.

• Strong attention to detail.

• Ability to multi-task, effectively problem-solve and work in a fast-paced environment.

• Must demonstrate a caring, compassionate, and patient attitude.

• Maintain & adhere to HIPAA compliance/ regulations.

• Ability to type a minimum of 40 words per minute.

Tech Requirements for the Job:

• High-speed, reliable internet connection to ensure uninterrupted communication and access to necessary systems and tools.

• Quiet and private work environment to maintain the confidentiality of patient information and minimize background noise during calls.

• Proficiency in using remote collaboration tools, such as video conferencing software, instant messaging platforms, and customer relationship management systems.

• Compliance with all security and privacy policies and protocols, including safeguarding patient information and maintaining HIPAA compliance.

Direct Reports:

• N/A.

Travel:

• This position does not require travel.

Physical Requirements for the Job:

• Regularly required to sit and stand for extended periods.

• Involves standing, sitting, walking, bending, stooping, and twisting.

• Requires full range of body motion, including manual and finger dexterity and eye-hand coordination.

• Occasionally lifts and carries items weighing up to 25 lbs.