Working directly with the Manager of Charge Integrity, the Charge Capture Specialist will be responsible for performing routine and special project analysis to assure the accuracy and completeness of charges captured for insurance and patient billing of inpatient and outpatient hospital services. Will verify and resolve discrepancies by utilizing the tools and resources available, e.g. Medipac/Epic billing systems, medical record documentation, Charge Master data, Patient Accounting/VMG Business Offices and/or contacting the appropriate internal department. The Charge Capture Specialist will also collaborate with the clinical department administrators in the development and implementation of educational activities related to charge capture improvement projects, along with reporting and presenting technical charge capture data as scheduled.
- Bachelor's Degree and 4 years of experience or the equivalent
- Â·Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting).
- Â·Knowledge of regulatory publications, how to access and interpret.
- Â·Working knowledge of medical terminology.
- Â·Solid oral and written communication skills.
- Â·Excellent analytical and problem-solving skills.
- Â·Experience with Microsoft Office (Word, Excel, PowerPoint).
- Bachelorâs degree with emphasis in Business Administration, Accounting, Healthcare Administration, Nursing, Health Information Management or other related healthcare concentration area with a minimum of 48 months of relevant experience. Experience may be substituted for education: basic qualification requirement on a 2:1 basis (2 years of experience for each year of education required, but not attained).
- Candidates with advanced business or healthcare related degrees and professional work experience in revenue cycle operations and/or clinical operations, particularly Radiology, Cardiology, and/or Interventional Radiology/Cardiology.
- Knowledge of government and commercial payer requirements to ensure accurate and compliant charging and billing of hospital inpatient, outpatient, surgical and ancillary services.
- Knowledge of CPT, HCPCs, and revenue codes.
- Knowledge of APC, fee for service, and DRG payment methodologies.
- Experience in utilizing computerized data analysis techniques/tools to identify charge capture issues.
- Working knowledge of VUMC or other major academic medical center clinical operations and related charge capture processes
- Coding experience in a hospital inpatient and outpatient setting and professional certification as a RHIA, RHIT, or CCS.
- Proficient User of Business Objects, Medipac, and EPIC