Charge Capture Specialist 1 WMCG

5000 Wellstar Medical Group, LLC; United States; On-site; USD 45,000 - 65,000; Full time

Job summary

Wellstar Health System is seeking a Charge Capture Specialist I to review clinical documentation ensuring timely, accurate, and compliant charge capture. You will educate Physician Practices on government and payer regulations, and collaborate with cross-campus teams to maintain consistent documentation in high-risk areas such as infusion services.

The role emphasizes developing training, identifying opportunities for process improvement, and maintaining HIPAA privacy standards while meeting

Qualifications

• Ability to perform mathematical calculations.
• Keyboard by touch for accurate data entry.
• Excellent communication with patients, families, and staff.
• Basic knowledge of medical terminology.
• Detail-oriented with strong organizational skills.
• Strong time management and ability to handle multiple priorities.

Responsibilities

• Ensure charging/documentation is accurate and complete across departments.
• Assess documentation to support charge codes and medical necessity.
• Review records to identify overcharges, undercharges, or missing documentation.
• Analyze and modify charging procedures for high risk areas (e.g., infusion services).
• Develop training to educate practices on changes to CDM related to high risk areas.
• Meet productivity and quality standards for accurate charge capture.

Skills

Mathematical calculations

Keyboard by touch

Excellent communication

Medical terminology

Detail oriented

Time management

Education

High School Diploma or GED

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift Day (United States of America) Job Summary: The Charge Capture Specialist I is responsible for reviewing clinical documentation to ensure timely, accurate, and compliant charge capture. The specialist works closely with Physician Practices as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges. The specialist also collaborates with cross-campus counterpart(s) and Physician Practice to ensure clinical documentation in high risk areas is consistent and complete. The Charge Capture Specialist I collaborates with cross-campus counterpart(s) to ensure consistency in processes in such a manner that each individual can act as a back-up for the other to ensure seamless charge capture in high risk areas when one individual is out.

Core Responsibilities and Essential Functions:

Job Functions

• Ensure charging/documentation is accurate and complete both department to department and cross-campus
• Assess physician and nursing documentation to ensure it supports the charge codes selected including supporting medical necessity
• Review the clinical records on an ongoing basis to identify any overcharges, undercharges, or charges that necessitate an additional document to be justified
• Analyze, verify, and work with departments to modify charging/documentation procedures for high risk areas such as infusion services
• Develop and implement training required to educate Physician Practices on the changes, updates, and additions to the CDM related to high risk area(s) such as infusion services
• Proactively identify and analyze new charging opportunities in coordination with assigned departments
• Research and analyze charge and coding requirements for new services and technologies
• Consistently meet the current productivity standards in ensuring accurate charge capture in high risk areas such as infusion services
• Consistently meet the current quality standards in ensuring accurate charge capture in high risk areas in a timely manner
• Meet productivity standards, benchmarks, targets, and reporting requirements as assigned by the department Manager or Supervisor

Management Professional Development

• Provide individual contribution to the overall team effort of achieving the department AR goal
• Identify opportunities for system and process improvement and submit to management
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
• Demonstrate knowledge of the health system HIPAA privacy standards and ensure compliance with system PHI privacy practices
• Follow the health systems general Policy and Procedures, the Departments Policy and Procedures, and the Emergency Preparedness Procedures
• Become cross-trained and fill in for other staff as assigned

Administrative Professional Communication

• Assure patient privacy and confidentiality as appropriate or required
• Ensure minors have a parent or guardian listed as guarantor as appropriate
• Communicate in a professional manner with patients, their families and representatives from third party payor organizations
• Communicate in a professional manner with physicians, physician staff, co-workers, management and clinical staff
• Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies
• Initiate communication with peers about changes and procedures
• Relay information appropriately over telephone, email, and other communication devices
• Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives

Department Methods/Procedures/Operations

• Follow department guidelines for lunch, breaks, requesting time off, and shift assignments
• Operate office equipment and machinery and utilizes ergonomic workstations, equipment, and supplies
• Follow JCAHO and outside regulatory agencies mandated rules and procedures
• Utilize assigned menus and pathways in the hospital mainframe system. Report software application problems to the appropriate supervisor
• Utilize assigned computer hardware. Report hardware problems to the appropriate supervisor
• Participate in the testing for assigned software applications, including verification of field integrity
• Perform other duties and responsibilities as assigned
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• High School Diploma General or GED General

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Required Minimum Experience:

• Minimum 2 years Collection experience Required
• Minimum 2 years experience with a Hospital Information System or PC-based applications Required

Required Minimum Skills:

• Ability to perform mathematical calculations
• Keyboard by touch
• Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices
• Basic knowledge of medical terminology
• Basic experience and knowledge of PC applications
• Detail-oriented, good organizational skills, and ability to be self-directed
• Ability to learn quickly and meet continuous timelines
• Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere
• Demonstrated flexibility to perform other tasks as needed in an active work environment with changing work needs
• High-level problem solving, analytical, and investigational skills
• Excellent internal/external customer service skills
• Excellent communication skills to include oral and written comprehension and expression
• Ability and willingness to exhibit behaviors consistent with principles of excellent service
• Ability and willingness to demonstrate and maintain competency as required for job title and the unit/area(s) of assignment
• Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency & finances, safety, partnership & service, teamwork, compassion, integrity, and trust & respect)

Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more. Nationally ranked and locally recognized for our high-quality care and inclusive culture, Wellstar is one of Georgia's largest and most integrated healthcare systems. Every day, 24,000+ of us work together to provide personalized care for patients at every age and stage of life - and our team members are the foundation of that care.

Mission, Vision & Values

At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients' and team members' expectations, while transforming healthcare delivery.

OUR MISSION:

To enhance the health and well-being of every person we serve.

OUR VISION:

Deliver world-class healthcare to every person, every time.

OUR VALUES:

We serve with compassion We pursue excellence We honor every voice Culture of Excellence

Wellstar consistently receives attention and accolades from national organizations that set the standards for world-class care. Our system-wide practice of safety principles, assessing and addressing errors and seeking feedback from our patients and customers continually earns recognition for advances in safety and quality. Featured on the FORTUNE "100 Best Companies to Work For" list and Seramount 100 Best Companies list, we not only provide top-notch care for our patients, but also foster the culture of Wellstar as a Great Place to Work.