Charge Integrity Specialist-Remote

Palomar Health Medical Group

1d•Remote

About The Position

The Charge Review Specialist ensures accurate and complete patient demographic, insurance, and charge information to reduce denials and support optimal reimbursement. This role reviews daily charge submissions, identifies and corrects errors, monitors trends, and collaborates closely with billing and coding teams to maintain high-quality revenue cycle performance.

Requirements

High School Diploma or equivalent
3 years of related experience in a physician office or medical billing environment with working knowledge of practice management billing systems

Nice To Haves

Associate degree in a related field preferred
5 plus years of experience related experience
NextGen experience
(CPC) Certified Professional Coder certification

Responsibilities

Review charge submissions from providers and charge entry staff for accuracy and completeness.
Identify, correct, and document errors to ensure clean claim submission.
Monitor and analyze trends in coding denials, claim edits, and open accounts to identify opportunities for improvement.
Conduct quality review tracking and auditing to ensure accuracy and compliance.
Perform charge reconciliation between the EHR and Practice Management systems.
Audit accounts and resolve billing questions or discrepancies.
Ensure adherence to insurance carrier claim submission guidelines.
Update patient accounts with accurate demographic, insurance, and charge information.
Review and correct electronic claim errors; attach required documentation for payment when necessary.
Prioritize daily workload to support timely reimbursement and reduce accounts receivable days.
Communicate trends and findings to supervisors and team members to support process improvement.
Ability to speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop-down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the first two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health Medical Group rules, policies, procedures, applicable laws, and standards. Carries out the mission, vision, and quality commitment of Palomar Health Medical Group.