Clinical Charge Analyst

Position Summary:

The Clinical Charge Analyst performs detailed audits of inpatient and outpatient medical accounts by comparing clinical documentation, itemized billing, and departmental charging practices to ensure accuracy and regulatory compliance. Working collaboratively with clinical departments and revenue cycle teams, this role identifies discrepancies, evaluates financial impact, and supports timely resolution of charging issues. As part of a coordinated and detail-focused team, the Clinical Charge Analyst contributes analytical insight and clear communication to support accurate charge capture and consistent billing practices.

Remote work may be permitted at management’s discretion.

Key Responsibilities:

Review medical records, itemized bills, and departmental documentation to validate charge accuracy.

Identify discrepancies and summarize audit findings, including financial implications.

Collaborate with departments to resolve charge issues and improve charging practices.

Support compliance with billing, documentation, and charge capture guidelines.

Maintain working knowledge of coding principles, billing rules, and charging processes.

Licenses and Certifications

Required:

None

Educational Requirements:

Associate's degree (or equivalent working experience in health care patient care setting) required; LPN, LVN, RN, RT, PT or OT required;
Bachelor's degree preferred.

Experience Requirements:

Experience with PCs, Outlook, word processing and spreadsheet software applications are desired.

Previous clinical auditing experience preferred.

Special Skills or Training Requirements:

Strong quantitative, analytical, and organization skills Proficient in chart review, clinical record information systems, and some coding methodologies.

Ability to understand and interpret medical records, hospital bills, and the charge master.

Ability to understand all ancillary department functions.

Ability to understand insurance terms (i.e. HMO/PPO, EOB, stop loss, etc.) and payment methodologies

Ability to communicate orally and in written form Ability to utilize and understand computer technology

Must be team oriented with strong interpersonal skills

Physical Requirements:

Work is primarily performed in a standard office or remote setting involving prolonged periods of computer use and document review. Adequate visual acuity and communication abilities are required for analyzing detailed records and reporting findings. Occasional onsite departmental interaction may be necessary.

Environmental Requirements:

The work environment is office based or remote with minimal exposure to environmental hazards. The role requires strict confidentiality when handling patient, financial, and organizational information. Frequent interaction with clinical, billing, and revenue cycle teams is expected, along with adaptability to evolving regulatory and billing requirements.