Charge Capture Specialist 2 WMCG

Wellstar Health System

57d

About The Position

The Charge Capture Specialist II is responsible for reviewing clinical documentation to ensure timely, accurate, and compliant charge capture. He/she works closely with Physician Practices as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges. The Charge Capture Specialist II also collaborates with cross-campus counterpart(s) and Physician Practice to ensure clinical documentation in high risk areas is consistent and complete. The Charge Capture Specialist II collaborates with cross-campus counterpart(s) to ensure consistency in processes in such a manner that each individual can act as a back-up for the other to ensure seamless charge capture in high risk areas when one individual is out. Duties include charge entry, ensuring correctness of coding in Charge Review, providing ongoing education to charging departments and reducing payor coding denials.

Requirements

High School Diploma Genetics or GED General
CCA - Cert Coding Associate or CCS-PH - Certified Coding Spec-Physican Based or COC - Cert Outpatient Coder or CPC - Cert Prof Coder
Minimum 2 years collection experience Required or Minimum 2 years experience with physician billing Required
Ability to perform mathematical calculations
Keyboard by touch
Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices
Basic knowledge of medical terminology
Basic experience and knowledge of PC applications
Detail-oriented, good organizational skills, and ability to be self-directed
Ability to learn quickly and meet continuous timelines
Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere
Demonstrated flexibility to perform other tasks as needed in an active work environment with changing work needs
High-level problem solving, analytical, and investigational skills
Excellent internal/external customer service skills
Excellent communication skills to include oral and written comprehension and expression
Ability and willingness to exhibit behaviors consistent with principles of excellent service
Ability and willingness to demonstrate and maintain competency as required for job title and the unit/area(s) of assignment
Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency & financial responsibility, safety, partnership & service, teamwork, compassion, integrity, and trust & respect)

Nice To Haves

Bachelors General-Preferred
ROCC credential through AMAC considered for positions in Radition Oncology in lieu of AAPC or AHIMA credential.

Responsibilities

Ensure charging/documentation is accurate and complete both department to department and cross-campus
Assess physician and nursing documentation to ensure it supports the charge codes selected including supporting medical necessity
Review the clinical records on an ongoing basis to identify any overcharges, undercharges, or charges that necessitate an additional document to be justified
Analyze, verify, and work with departments to modify charging/documentation procedures for high risk areas such as infusion services
Develop and implement training required to educate Physician Practices on the changes, updates, and additions to charge review.
Proactively identify and analyze new charging opportunities in coordination with assigned departments
Research and analyze charge and coding requirements for new services and technologies
Consistently meet the current productivity standards in ensuring accurate charge capture
Consistently meet the current quality standards in ensuring accurate charge capture in high risk areas in a timely manner
Meet productivity standards, benchmarks, targets, and reporting requirements as assigned by the department Manager or Supervisor
Provide individual contribution to the overall team effort of achieving the department AR goal
Identify opportunities for system and process improvement and submit to management
Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
Demonstrate knowledge of the health system HIPAA privacy standards and ensure compliance with system PHI privacy practices
Follow the health systems general Policy and Procedures, the Departments Policy and Procedures, and the Emergency Preparedness Procedures
Become cross-trained and fill in for other staff as assigned
Assure patient privacy and confidentiality as appropriate or required
Ensure minors have a parent or guardian listed as guarantor as appropriate
Communicate in a professional manner with patients, their families and representatives from third party payor organizations
Communicate in a professional manner with physicians, physician staff, co-workers, management and clinical staff
Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies
Initiate communication with peers about changes and procedures
Relay information appropriately over telephone, email, and other communication devices
Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives
Follow department guidelines for lunch, breaks, requesting time off, and shift assignments
Operate office equipment and machinery and utilizes ergonomic workstations, equipment, and supplies
Follow JCAHO and outside regulatory agencies mandated rules and procedures
Utilize assigned menus and pathways in the hospital mainframe system. Report software application problems to the appropriate supervisor
Utilize assigned computer hardware. Report hardware problems to the appropriate supervisor
Participate in the testing for assigned software applications, including verification of field integrity
Perform other duties and responsibilities as assigned
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.