Charge Capture Analyst, FT, Days
Required skills
- charge capture
- revenue reconciliation
- revenue trending
- charge review audits
- Epic
- medical documentation
- principal diagnosis
- secondary diagnoses
- principal procedures
- secondary procedures
Nice to have
- RHIT
- RHIA
- CCS
- CPC
- CRCA/CRCR
- CBCS
Role summary
Prisma Health is seeking a Charge Capture Analyst to monitor charge capture, revenue reconciliation, and revenue trending. The analyst will conduct focused charge review audits for assigned clinical departments to ensure compliance with policies and timeframes. Responsibilities include validating diagnoses and procedure codes, advising on charge code usage, identifying revenue capture opportunities, and developing specifications for charge capture applications. The role also involves reviewing billing guidelines, regulations, and assisting with reconciliation auditing, reporting, and education. Collaboration with vendors for optimization projects is also required.
Inspire health. Serve with compassion. Be the difference.
Job Summary
Interacts with departmental revenue owners to monitor charge capture, revenue reconciliation and revenue trending across Prisma Health. Completes focused charge review audits for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes.Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
Works assigned Epic charge review and billing work queues to meet our compliant standardized min daytime frame, ensuring appropriate medical documentation exists to support charge capture compliance.
Validates assigned principal diagnosis, all secondary diagnoses, principal procedures, and all secondary procedures and CPT/HCPCs codes.
Advises departmental revenue owners and their staff on proper usage of charge codes, identifies opportunities for capturing additional revenue in accordance with payer guidelines and develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
Reviews and applies appropriate billing guidelines, state and federal regulations, and third-party billing rules/coverage.
Completes internal charge review audits for assigned clinical departments to ensure that charges are generated in accordance with established policies and timeframes. Assist with monthly, quarterly, and yearly Charge capture revenue reconciliation auditing, reporting and education.
Partners with vendors for optimization projects to complete data review, auditing, and testing.
Performs other duties as assigned.
Supervisory/Management Responsibility
This is a non-management job that will report to a supervisor, manager, director, or executive.
Minimum Requirements
Education - High School diploma or equivalent OR post-high school diploma/highest degree earned
Experience - Three (3) years of Health care revenue cycle related experience
In Lieu Of
In lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: Associate degree
In lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: Health Science/Business/Coding Certificate and two (2) years healthcare revenue cycle related experience
Required Certifications, Registrations, Licenses
Job Related Certification in one of the following: RHIT, RHIA, CCS, CPC, CRCA/CRCR, or CBCS preferred.
Knowledge, Skills and Abilities
Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
Ability to understand and apply National and Local Coverage Determination to complete assigned work queues and educate facility departments routinely.
Work Shift
Day (United States of America)Location
Patewood Outpt Ctr/Med OfficesFacility
CorporateDepartment
Revenue IntegrityShare your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
