RN Coding Reimbursement Specialist

RN Coding Reimbursement Specialist

We are seeking a detail-oriented and highly skilled RN Charge Review Analyst to oversee and ensure the accuracy of facility charging for various clinical departments, including but not limited to the Emergency Room (ER), Immediate Care Centers, Cancer Center and Infusion Services. This position plays a critical role in reviewing and validating charges for services rendered, ensuring compliance with healthcare regulations, payer requirements, and internal policies. The RN Charge Review Analyst will work closely with clinical and billing teams to optimize revenue cycle performance while maintaining high standards of patient care and operational efficiency.

Position Highlights:

• Location: Edward Hospital (Naperville, IL)
• Full Time/Part Time: Full Time
• Hours: Monday-Friday, 7:00am-3:30pm
• Required Travel: travel to other Endeavor Health locations may be required

What you will do:

• Charge Review & Validation
• Review and analyze charges for services provided in various clinical departments.
• Verify that charges align with clinical documentation and ensure proper coding and charge capture for all services.
• Identify discrepancies or errors in charging and collaborate with clinical and billing teams to resolve issues in a timely manner.
• Clinical Documentation & Charge Reconciliation
• Collaborate with healthcare providers and clinical staff to ensure accurate and complete clinical documentation that supports the charges for services rendered.
• Perform charge reconciliation to ensure that all patient encounters are accurately reflected in the billing system and are in compliance with payer guidelines.
• Compliance & Regulatory Oversight
• Ensure all charges are compliant with healthcare regulations, and internal policies, including HIPAA and other relevant healthcare standards.
• Assist in audits of clinical charges to ensure appropriate reimbursement and regulatory compliance.
• Reporting & Data Analysis
• Notify leadership of identified trends and opportunities for improvement.
• Provide feedback and recommendations to clinical leadership and management on charge capture efficiencies and best practices.
• Collaboration & Communication
• Serve as a liaison between clinical departments, billing teams, and leadership to address charge-related issues and improve processes.
• Provide education and training to clinical staff regarding charge capture, documentation requirements, and compliance standards.
• Process Improvement
• Identify opportunities to streamline and improve charge capture workflows, reducing errors and enhancing overall revenue cycle performance.
• Participate in ongoing process improvement initiatives to enhance the accuracy and timeliness of billing processes.

What you will need:

• Education: BSN, preferred
• Certification: Active RN License in Illinois
• Experience:
• 2+ years of experience in a clinical or healthcare revenue cycle role, with a strong understanding of facility charging, coding, and billing processes.
• Experience in charge review or revenue cycle management within an Emergency Room, Immediate Care Center, Cancer Center or Infusion Services setting preferred.
• Unique or Preferred Skills:
• Knowledge of regulatory requirements related to billing, coding, and charge capture.
• Familiarity with CPT codes.
• Strong attention to detail and analytical skills.
• Excellent communication skills and the ability to work collaboratively with clinical and billing teams.
• Proficiency with electronic health records (EHR) and billing software systems.
• Ability to interpret clinical documentation and align it with appropriate charges.

Benefits (For full time or part time positions):

• Opportunity for annual increases based on performance
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities