Ambulatory Charge Capture Analyst

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The Ambulatory Charge Capture Analyst serves as an embedded revenue cycle specialist within assigned clinical department(s), ensuring accurate and complete charge capture for all billable services, procedures, and supplies. This role bridges clinical operations and revenue cycle functions by providing dedicated expertise in charge reconciliation, staff education, and process improvement. The analyst reports directly to Ambulatory Administration, with a strong collaborative relationship to the department leadership (matrixed reporting).

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school diploma AND six (6) years of experience in business analysis or clinical/nursing experience

OR bachelor's degree in finance, business management, information technology/computer science, healthcare administration, nursing or related field AND two (2) years of experience in business analysis or clinical/nursing experience, or similar role.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Lean Six Sigma certification.

EXPERIENCE:

1. Experience with Lean Six Sigma.

2. Experience with revenue cycle.

3. Experience with excel, power point, tableau, etc.

4. Experience with the development and maintenance of metrics and communication dashboards.

5. Experience with EPIC electronic health record.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Conduct daily/weekly reconciliation of clinical activity against billed charges for assigned department(s).

2. Review case/procedure schedules, supply usage, and documentation to identify missing, incorrect, unbilled charges.

3. Validate that all chargeable services, procedures, implants, devices, and supplies are accurately captured in the billing system.

4. Investigate discrepancies between documented services and charges submitted.

5. Take corrective action for missing charges in accordance with Revenue Integrity system team guidelines.

6. Monitor charge lag time and ensure timely charge entry to support claim submission deadlines.

7. Identify patterns of revenue leakage and recurring charge capture errors.

8. Serve as the primary resource for department staff on charge capture policies, procedures, and best practices.

9. Provide ongoing education to clinical and administrative staff regarding chargeable items and proper documentation requirements.

10. Develop and deliver training materials, quick reference guides, and workflow tools specific to department needs.

11. Communicate updates to Revenue Integrity System team any changes that impact charge capture.

12. Act as liaison between department staff and Revenue Integrity System team to answer questions and resolve issues.

13. Generate and analyze reports to track charge capture performance, revenue recovered, and compliance metrics.

14. Prepare regular updates for Revenue Integrity leadership and department management on findings, trends, and opportunities.

15. Maintain documentation of charge corrections, revenue impact, and root cause analysis.

16. Monitor key performance indicators including reconciliation completion rates, charge accuracy, and financial impact.

17. Support internal and external audits by providing documentation and analysis as needed.

18. Collaborate with Revenue Integrity leadership, IT, and department stakeholders to implement sustainable solutions.

19. Participate in new service line implementations and system upgrades to ensure proper charge capture from launch.

20. Participate in Revenue Integrity team meetings and cross-departmental initiatives.

21. Build strong working relationships with coding, billing, compliance, and clinical documentation teams.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Must be able to sit for long periods of time.
2. Must have visual and hearing acuity within the normal range.
3. Must have manual dexterity needed to operate a computer and office equipment.
4. Must be able to lift, push or pull 10-20 pounds.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Standard office equipment.
2. Visual strain may be encountered by viewing computer screens, spreadsheets, and other written material.
3. May require travel.

SKILLS AND ABILITIES:

1. Must possess excellent written and verbal communication skills, as well as interpersonal skills necessary to communicate effectively.

2. Must possess the knowledge of related provider healthcare compliance, revenue cycle operations and auditing techniques required.

3. Must possess the ability to mentor, educate and train others.

4. Must ensure quality and productivity standards.

5. Must be able to handle high stress and critical situations in a calm and professional manner.

6. Must be able to concentrate and maintain accuracy during constant interruptions.

7. Must possess independent decision-making ability.

8. Must possess the ability to prioritize job duties.

9. Must be able to adapt to changes in the workplace and work assignments.

10. Must possess organizational and time management skills.

11. Must possess the knowledge of anatomy, physiology, and medical terminology.

12. Must possess analytical and problem-solving skills.

13. Must be proficient in office software programs including medical record and billing systems.

14. Must possess the ability to analyze complex data and reports.


15. Specific understanding of APC/MPFS payment structures and other third-party payment methodologies.

Additional Job Description:

Scheduled Weekly Hours:
40

Shift:

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
WVUH West Virginia University Hospitals

Cost Center:
500 UHA Administration

Address:
1 Medical Center Drive

Morgantown

West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.