OverviewResponsible for charge capture analysis, workflow and maintenance of related work queues in assigned service lines. Works designated work queues to resolve claim edits prior to billing by analyzing medical record documentation and application of payer guidelines. The position will evaluate and provide guidance related to billing and/or clearinghouse system edits. May complete focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes. Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.ResponsibilitiesResponsible for charge capture analysis, workflow and maintenance of related work queues in assigned service lines. Works designated work queues to resolve claim edits prior to billing by analyzing medical record documentation and application of payer guidelines. The position will evaluate and provide guidance related to billing and/or clearinghouse system edits. May complete focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes. Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.QualificationsEducation H.S. Diploma or General Education Degree (GED) RequiredAssociate's Degree in HIM/HIT Preferred orBachelor's Degree in HIM/HIT PreferredWork Experience 3 years of related healthcare experience focused in one or more of the following areas: charge integrity Requiredcharge capture/reconciliation Requiredhealthcare compliance Requiredcharge auditing RequiredCDM management Requiredcoding and/or hospital billing procedures RequiredExperience working with Epic RequiredLicenses and Certifications AHIMA certification (e.g. RHIA, CCS, RHIT) Upon Hire Required orRN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure RN licensure Upon Hire Required orcertified healthcare provider (e.g. MT, RT) Upon Hire RequiredBusiness Unit : Company NamePiedmont Healthcare Corporate#J-18808-Ljbffr
