Charge Capture Auditor
Job DescriptionThe Charge Capture Analyst is responsible for the accuracy and efficiency of the daily technology functionality and workflow of charge master activities. This position will facilitate the resolution of undercharges, overcharges and coding errors to assure appropriate and compliant revenue. Analysis charges to identify trends of missing or misdirect charges to resolve charge capture related issues.
Education: Bachelor’s degree from an accredited four year university in related field or equivalent relevant experience and certification.
- Licenses/Certifications: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or Current Active Texas State nursing license is preferred.
- Three (3) years of experience in healthcare, specifically on revenue cycle operations, charging, coding, finance, auditing or related experience.
- Knowledge of hospital revenue cycle operations, hospital charge masters, as well as hospital department charge capture and charge reconciliation.
- Knowledge of correct coding principles of CPT/HCPCS, ICD-9/10 and modifier selection, as well as UB04 revenue codes.
- Understanding of Federal, State and Local coding guidelines and payment methodologies.
- Understanding of auditing concepts preferred.
- Must possess excellent analytical, organizational, verbal and written communication skills and be professional in both appearance and approach.
- Must be proficient in MS Office, particularly Excel and Word, and be very detail-oriented.
- Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of “we advance health” through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Memorial Hermann.
- Works with Sr. Auditor in conducting coding and documentation reviews of patient records to ensure provider billing practices are complaint with applicable rules and regulations. Ensures accurate and compliant charge capture.
- Serves as a knowledge resource for coding and billing auditing functions.
- Provide routine oversight to ancillary and clinical departments related to charge capture and charge reconciliation to ensure all services rendered are captured and posted to the patient’s account accurately and on a timely basis.
- Ensure the sustainability and integrity of charge capture initiatives through consistent audits, communication of results and development of training materials, as necessary.
- Manually distribute account exceptions to the appropriate clinical departments when required for resolution within a reasonable time frame.
- Participate in testing of upgrades and system enhancements as they relate to charge capture.
- Monitor effectiveness of departmental corrective action plans regarding charge capture and charge reconciliation.
- Review new edits/rules on a monthly basis to ensure changes will apply to hospital charging practices; alert assigned account manager regarding rules that apply so they can be added to our queue.
- Create and manage special projects to improve revenue cycle outcomes.
- Run resolution reports weekly; provide to Director, Revenue Operations for review. Review and summarize results for improvements needed and successes identified on a quarterly basis.
- Provides training to ensure accurate charge capture and consistency clinical documentation; in the use of charge tools and charge entry systems.
- Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
- Other duties as assigned.