Charge Entry Specialist I/II

Tuba City Regional Health Care Corporation (TCRHCC); Tuba City (AZ); Hybrid; USD 30,000 - 45,000; Full time

Job summary

Tuba City Regional Health Care Corporation (TCRHCC) is seeking a Charge Entry Specialist in Tuba City, Arizona. The incumbent will perform specialized functions by reviewing and analyzing charging procedures in a clinical setting, ensuring compliance with established guidelines. Applicants with medical coding experience are encouraged to apply.

This role is eligible for telework after a training period and requires adherence to TCRHCC telework policies.

Qualifications

• High School Diploma or GED is required.
• Three months experience with medical coding or charging for Charge Entry Specialist I.
• Two years of medical charging experience for Charge Entry Specialist II.
• Certificate in medical coding required for Charge Entry Specialist II.

Responsibilities

• Select appropriate charge codes based on procedures performed.
• Ensure compliance with charging guidelines.
• Analyze and report on charge integrity opportunities.
• Maintain expertise in patient account system and Charge Description Master.

Skills

Medical coding

Charge entry

Data analysis

Time management

Education

High School Diploma or GED

Job description

Job Description

Navajo Preference Employment Act: In accordance with Navajo Nation and federal law, TCRHCC has implemented an affirmative action plan pursuant to the Navajo Preference in Employment Act. Pursuant to this plan and corresponding TCRHCC policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally‑recognized American Indian Tribes will be given tertiary preference.

Overview

The incumbent performs highly technical and specialized functions by reviewing, analyzing, and charging procedures performed in the clinic setting. The primary function is to select the appropriate charge codes based on the procedure(s) performed. This charging function is the primary source for data and information used in health care reimbursement, promoting provider/patient continuity and accurate database information. The charging function ensures compliance with established charging guidelines, third‑party reimbursement policies, regulations, and accreditation guidelines. The position is eligible for teleworking with supervisor approval after a successful training/trial period. Teleworkers must have a reliable internet connection with a minimum 20 Mbps speed and must use VMware Horizon 7 when working off‑site. They are responsible for complying with all TCRHCC telework policies and procedures.

Qualifications

Education

High School Diploma or GED

Experience

• Charge Entry Specialist I: Three (3) months experience with medical coding or charging
• Charge Entry Specialist II: Two (2) years of medical charging experience

Certification

• Charge Entry Specialist II: Certificate in medical coding

Mental and Physical Effort

Physical

The work is primarily sedentary with requirements to sit for prolonged periods, twist and reach frequently, and occasionally stand, walk, drive, bend, climb, kneel, crouch, and maintain balance. The employee must be able to pick up objects from the floor without restrictions and have full use of hands and arms to operate office equipment such as computer, calculator, printer, and fax. Prolonged use of a keyboard with repetitive finger movement is required. Sensory requirements include near vision, color vision, depth perception, and hearing normal speech. The work involves hearing overhead pages over a loudspeaker and telephone use, with occasional need for far vision.

Mental

Exercise a high degree of judgment and leadership in planning, organizing, staffing, directing, evaluating, and managing business office activities. The employee must organize, set priorities, develop and implement solutions, motivate personnel, and operate the department within the constraints of the Joint Commission, budget, and regulatory agencies. Ability to interact across all disciplines, make decisions under high pressure, handle multiple priorities in stressful situations, adapt to shift work, and work in crowded areas is required. The employee must concentrate for prolonged periods, handle high flexibility, work independently, and demonstrate patience. Accepting a flexible schedule to meet unit needs is required.

Environmental

Employee will occasionally be exposed to infectious disease, chemical agents, dust, fumes, gases, extreme temperatures or humidity, hazardous or moving equipment, unprotected heights, and loud noises.

Responsibilities

Charging Specialist I

• Relies on instruction and pre‑established guidelines to perform the functions of the job.
• Works under immediate supervision or team lead.

Charging Specialist II

• Relies on limited experience and judgment to plan and accomplish goals and performs a variety of tasks.
• Works under general supervision with a certain degree of creativity and latitude.
• Receives and reviews charge documents from the Emergency Department, clinics, or inpatient services.
• Abstracts all necessary information and assigns charge codes that most accurately describe each documented note, surgical procedure, and special therapy or procedure according to established guidelines.
• Ensures charge information is correct and accurate, analyzing provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct medical code.
• Supports charge description master maintenance efforts and initiatives.
• Coordinates revenue enhancement opportunities for all entities supported by the Revenue Integrity Department leadership.
• Balances Charge Summary to Charge Order Sets or Superbills before updating charges.
• Keeps supervisor or lead apprised of charge entry matters, including errors and escalations.
• Enters charges in a timely manner in a high‑volume setting; minimum expectation is to complete charging for 120 ambulatory visits per day. Inpatient charging is expected within one day of service.
• Analyzes, evaluates, and reports, reviews and follows up on daily reports to identify accounts that may have potential lost, over, undocumented, or duplicate charges.
• Works with 3rd‑party vendor identifying missed charges, work queue as assigned, and rebill accounts accordingly.
• Reviews and follows up on daily reports to identify late charges.
• Researches, identifies, prioritizes, and communicates charge integrity opportunities.
• Contributes to revenue risks and opportunities management and tracking efforts.
• Contributes strategic pricing processes to include annual and periodic pricing updates, CPT/HCPC updates, fee schedule queries, and procedure queries.
• Works collaboratively across disciplines and communicates with various customers while seeking solutions.
• Prioritizes ad‑hoc meetings as needed to provide support in areas of expertise.
• Maintains expertise in the patient account system and Charge Description Master (CDM).
• Follows up with clinical, coding, billing, and operational contacts to resolve revenue integrity concerns in a timely manner.
• Works with revenue integrity, finance, and clinical leadership to develop, implement charge capture entry, validation, reconciliation, and correction processes; developing and implementing protocols, policies, and procedures to support charge capture accuracy and timeliness.
• Keeps current with trends, developments in the profession, industry, and related fields of expertise.
• Has an understanding of revenue cycle concepts and knowledge of clinical concepts.