Charge Review Specialist

Overview

Responsible for performing timely review of charges in the charge review queues. Verify completeness of the charge information, add and/or update as needed. Research charges for appropriate codes, modifiers and diagnosis codes based on edits within the Epic system. Utilize resources and tools to review and interpret key data elements following company policy for contracted payors.

• Accurately perform actions on the charges in the charge review queues for each patient encounter.
• Review, verify and interpret payor edits in the system.
• Timely identify, research and resolve issues that may cause delays in resolution.
• Inform Team Leader on the status of work and unresolved issues; alert Team Leader of backlogs or issues requiring immediate attention.
• Identify clinic trends and provide essential reporting functions as required.
• Perform special projects as assigned by the Team Lead or Manager.
• Respond and send emails to different levels of management within the Business Groups, Clinics, etc. to resolve charge issues.
• Review and work assigned WQ's on a daily basis to make any corrections, resolve edits and submit to the payor.

• 2 years computer experience in medical billing required.
• 2 years healthcare experience in medical billing preferred.
• 2 years medical billing software required.
• High School Diploma or GED equivalent required;
  Associate's preferred.
• Medical Terminology Certificate preferred at time of hire.
• Experience with online payor tools preferred.

UFJPI IS AN EQUAL OPPORTUNITY EMPLOYER AND DRUG FREE WORKPLACE

• Entry level

• Full-time

• Other

• Hospitals and Health Care