Charge Capture Specialist - PRN Days

20 Northeast Georgia Medical Center, Inc.; Georgia; Hybrid; USD 45,000 - 65,000; Full time

Job summary

Northeast Georgia Health System is seeking a detail-oriented individual to ensure proper charge capture and compliant billing practices. The role focuses on ED and hospital services, using electronic systems and manual processes to review medical records and correct discrepancies.

You will work to identify chargeable services, calculate E/M levels, and enter charges within 72 hours of discharge, aiming for high accuracy and timely billing, in a collaborative healthcare environment.

Qualifications

• Working knowledge of medical terminology, anatomy, physiology, medications and CPT/HCPCS.
• Charge entry/capture experience and hospital policy understanding are preferred.
• Experience with McKesson and hospital billing processes is advantageous.

Responsibilities

• Identify all chargeable ED services and supplies.
• Calculate ED E&M level.
• Identify CPT-based charges for ED and outpatient services.
• Enter charges, quantities and modifiers within 72 hours of discharge.
• Maintain high completion rate of charges within 72 hours.
• Identify documentation deficiencies affecting billing and notify originators.
• Collaborate with auditors on charge accuracy for insurance and patient billing.
• Assist with rebill projects and cross-department charge capture initiatives.
• Serve as liaison between clinical and billing staff regarding charges and audits.
• Perform other duties as assigned.

Skills

Charge entry/capture experience

Medical terminology

Anatomy

Physiology

CPT/HCPCS

Education

High School Diploma or GED

Tools

McKesson

Microsoft Office

Job description

Job Category: Revenue Cycle Work Shift/Schedule: 8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role

Job Summary This position is responsible for facilitating proper charge capture in accordance with standard billing policies and clinical documentation practices through the use of the hospital's electronic information systems, manual processes, and review of the medical record. Identifies inconsistencies in medical reports and works with healthcare staff to improve charge capture and error correction. Follows compliant charge capture program and billing practices in accordance with Medicare, Medicaid, or Third Party payor guidelines. All functions of this role shall be performed within the guidelines of the department and hospital policies.

Minimum Job Qualifications

Licensure or other certifications: Educational Requirements: High School Diploma or GED Minimum Experience: Minimum two (2) years hospital, medical, or billing experience. Other:

Preferred Job Qualifications

Preferred Licensure or other certifications: Preferred Educational Requirements: Working knowledge of medical terminology, anatomy, physiology, medications, and CPT/HCPCS. Preferred Experience: Charge entry/capture experience, working knowledge or hospital policies and procedures, and experience with McKesson. Other:

Job Specific and Unique Knowledge, Skills and Abilities

Working knowledge or Microsoft Office products required Understanding of the composition of a medical record, and the ability to read and interpret it is essential Displays problem solving ability, initiative, reasoning ability, decision making techniques, is detailed oriented, and appropriate use of resources Demonstrated ability to interact professionally on the phone and in person with staff, doctors, and supporting departments.

Essential Tasks and Responsibilities

• Identify all chargeable ED services and supplies.
• Calculate ED Evaluation and Management (E&M) level.
• Identify infusion, injection, and transfusion charges per existing Current Procedural Terminology (CPT) hierarchy guidelines for ED and outpatient/bedded outpatient services.
• Enter charges, quantities, and modifiers, when indicated, within 72 hours of the patient's discharge.
• Maintains greater than 97% completion rate of charges in less than 72 hours.
• Identify deficiencies or discrepancies in nursing and/or physician documentation that affects billing and notifies the originator of the incorrect documentation to allow for proactive improvements related to charge capture.
• Collaborate with Nurse Auditor on routine and special project analysis to assure the accuracy and completeness of charges captured for insurance and patient billing of inpatient and outpatient hospital services.
• Assist special projects related to charge capture and rebill projects.
• Collaborate and assist other departments to address charge capture/documentation issues and assist with the development of educational opportunities.
• Serve as a communication link between clinical/billing personnel and other reimbursement specialists in discussing issues, recommendations, solutions, and answering questions related to patient charges, auditing, and charge master.
• Perform other duties as assigned.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
• Vision: Moderate, Occasionally 0-30% of time
• Kneeling/Stooping/Bending: Occasionally 0-30%
• Standing/Walking: Frequently 31-65%
• Pushing/Pulling: Occasionally 0-30%
• Intensity of Work: Frequently 31-65%

% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

Northeast Georgia Health System (NGHS) is a non-profit on a mission of improving the health of our community in all we do.

Our team cares for more than 1 million people across the region through five hospitals and a variety of outpatient locations.

Northeast Georgia Medical Center (NGMC) has campuses in Gainesville, Braselton, Winder, Dahlonega and Demorest - with a total of more than 850 beds and more than 1,200 medical staff members representing more than 60 specialties.

Learn more at www.nghs.com.