Charge Entry Specialist, Business Office, Downtown Nashville

SUMMARY: The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice.ESSENTIAL DUTIES AND RESPONSIBILITIES:Captures and reviews daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly.Utilizes CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services. Other specialties may be added based on performance level.Communicates effectively and respectfully, both in verbal and written form, with providers or clinical staff to obtain missing or incomplete information.Audits the imported encounters against the daily appointment schedule to ensure all encounters have been captured correctly.Reviews and finalizes daily summary reports prior to close of day.Prepares all end-of-day charge and payment batch documents for Scanning Department.Reviews encounter tracking reports to ensure all encounters are accounted for in a timely manner.Alerts department supervisor of any issues needing further research.Fulfill month end requirementsSecondary Responsibilities:Maintains strong knowledge of both local and national CMS policies, as well as various private-payer coding and billing guidelines.Utilizes the Correct Coding Initiative Edit List (CCI) when billing for multiple services during the same encounter and understands how to correctly apply Modifiers.Informs Patient Accounts Department when additional account balance reviews are needed.Researches front-end claim rejections and works cooperatively with appropriate staff to resolve discrepancies.Utilizes various coding and billing references to resolve complex billing scenarios.Consistently follows internal coding and billing protocols and policies.Demonstrates a commitment to expand coding & billing knowledge by participating in various continuing education opportunities each year.Demonstrates a positive willingness to take on additional assignments and responsibilities.Must maintain professional and courteous relationships with all team members at all times.Must have predictable and consistent attendance and follow all attendance policies.SUPERVISORY RESPONSIBILITIESNoneCERTIFICATES, LICENSES, AND REGISTRATIONSActive Certified Coder License preferred (CPC, CCS)EDUCATION and/or EXPERIENCEHigh school diploma requiredOB/GYN Coding Experience Preferred5+ years of Charge Entry or Medical Billing experience requiredMulti-Specialty physician coding experience preferredCompletion of an accredited Medical Coding/Billing Program preferredMust have knowledge of CPT and ICD10Experience with EPIC EMR System and Electronic Charge Capture preferredKNOWLEDGE, SKILLS, AND ABILITIESAdvanced knowledge of CPT, ICD-10CM, HCPCS coding and of Modifier usage for multiple specialtiesKnowledge of CMS billing and documentation guidelines and CCI Edit ListsAdvanced understanding of medical documentation requirements for E/M coding and office proceduresAbility to abstract key information from the medical record to ensure accurate codingEffective communication skills, to explain guidelines to new employees in an easy to understand mannerExcellent computer skills, including advanced typing speed, ten-key and mouse click selection skillsAbility to easily and quickly maneuver through various computer software programs such as MS Outlook, Word, Excel, electronic health records, patient billing systems, and other medical information software systemsExceptional attention to detail and the ability to quickly identify discrepancies or uncommon billing situationsStrong judgment skills and ability to work through complex matters independentlyExcellent time management and organizational skillsAbility to prioritize work responsibilities and complete assignments in a timely fashionStrong initiative to anticipate departmental needs and work supportively to respond to such needs.Ability to work effectively and cooperatively with all levels of management, physicians, team colleagues, and other departments.PHYSICAL DEMANDSMust be able to sit for long periods of timeRequires moderate walking, bending, pushing, pulling, twisting and liftingMental alertnessWORK ENVIRONMENTHigh volume, faced paced office environment with a strong commitment to timeliness and organizationOffice environment-limited exposure to communicable diseases.No exposure to blood-borne pathogens or contaminated body fluids #J-18808-Ljbffr