Surgery Billing Clerk

WVU Medicine Thomas Hospitals; South Charleston (WV); On-site; USD 50,000 - 70,000; Full time

Job summary

THOM Thomas Hospitals in South Charleston, WV seeks an experienced healthcare charging specialist to review and process charges, ensuring accuracy across EPIC and Lawson systems. You will validate procedures, support hospital departments, and maintain compliance with coding requirements.

The role requires knowledge of ICD-10/CPT coding, experience in hospital billing, and the ability to work independently in a fast-paced environment.

Qualifications

• High School education or equivalent.
• Two years experience in health care finance.
• Two years experience in health care environment with hospital billing and/or charging knowledge.
• CPC Certification or LPN preferred.
• CRCR certification within 2 years of employment.

Responsibilities

• Maintains accurate and timely flow of charges incurred by patients in assigned area.
• Picks up daily surgery and procedure records for all assigned areas after they have been logged and validates charges for payment.
• Calculates charges following hospital mark‑up schedule and applies charges in key areas such as OR room time and room rate based on procedures.
• Extracts and compiles charges for regular, pharmacy, and special items.
• Completes daily audit routines to ensure appropriate codes on claims.
• Uses EPIC modules daily for review accuracy (Cupid, OP Time, dashboards).
• Initiates new procedures or items in Lawson and EPIC with correct amounts and codes.
• Maintains dialogue with hospital departments for charge clarification and adjustments.

Skills

Communication skills

Independent work

Medical terminology

Windows-based software

Data entry

ICD-10 and CPT coding

Flexibility

Education

High School diploma

CPC Certification

CRCR certification within 2 years

Tools

EPIC

Lawson

Cupid

Job description

Processes and reviews charging activity in respective hospital assigned areas, and reports system issues and clarification when opportunity for improvements are identified. Provides guidance to supply chain regarding items to be paid and reconciles against clinical documentation.

MINIMUM QUALIFICATIONS

EDUCATION, CERTIFICATION, AND/OR LICENSURE

• High School education or equivalent.

EXPERIENCE

• Two years previous experience in a health care finance.

PREFERRED QUALIFICATIONS

EDUCATION, CERTIFICATION, AND/OR LICENSURE

• Certified Professional Coder (CPC) Certification or Licensed Practical Nurse (LPN) preferred.


• Obtain Certified Revenue Cycle Representative (CRCR) certification within 2 years of employment.

EXPERIENCE

• Two years previous experience in a health care environment with hospital billing and or charging knowledge.

CORE DUTIES AND RESPONSIBILITIES

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

• Maintains an accurate and timely flow of charges incurred by patients in assigned area.


• Picks up daily surgery and procedure records for all assigned areas after they have been logged. Validates usage and processes for payment according to work flow established by materials management.


• Calculates charges as directed with hospital standard mark-up schedule and other assigned functions in key areas such as OR Room Time & Apply Room Rate based on procedure done.


• Extracts & Compiles charges for regular, pharmacy, and special items used.


• Completes daily audit routines including working the OR work queue for financial services to ensure appropriate codes are on claims.


• Utilizes various EPIC modules daily for review accuracy such as Cupid, OP Time, and various dash boards.


• Initiates new procedures or items in Lawson and EPIC with appropriate charge amounts and codes as directed in a timely and accurate fashion.


• Maintains active dialogue and analyzes volume with other Hospital departments assisting with clarification for charges and adjustments.


• Demonstrates ability to follow established computer down time procedures.


• Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth including departmental meetings.


• Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information.


• Complies with Notices of Privacy Practices, and the Patient’s Rights and Responsibilities.


• Demonstrates knowledge of procedure to report and/or document unsafe/hazardous conditions, incidents and defective equipment in compliance with hospital policy.


• Communicates problems hindering workflow to management in a timely manner.

PHYSICAL REQUIREMENTS

• Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.


• Must be able to sit for extended periods of time.


• Must have reading and comprehension ability.


• Visual acuity must be within normal range.


• Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects.


• Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

WORKING ENVIRONMENT

• Normal Office environment.


• Patient Care environment.

SKILLS AND ABILITIES

• Must possess good communication skills.


• Ability to work independently.


• Knowledge of medical terminology.


• Experience with Windows-based software.


• Experience with data-entry.


• Current knowledge of ICD-10 and CPT coding requirements.


• Demonstrates flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs (i.e. weather or disaster).

Scheduled Weekly Hours

40

Exempt/Non-Exempt

United States of America (Non-Exempt)

Shift

United States of America (Non-Exempt)

Company

THOM Thomas Hospitals

Cost Center

72 THOM Nursing Operating Room

Address

4605 Maccorkle Ave SW
South Charleston
West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively \"WVUHS\") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.