Charge Capture Reconciliation Specialist

Charge Capture Reconciliation Specialist

Date Posted: June 12, 2018
Department: Finance
Status: Full-Time
Shift: 1st Shift

It is the mission of Graham Health System to provide compassionate, quality health services, in a responsible and charitable manner, to the people and communities we serve. We are the community’s choice for an exceptional healthcare experience. Graham Health System is seeking a great applicant to join our team. Graham Health System offers a great team atmosphere with multiple benefits.

This position works in conjunction with Corporate Compliance and Revenue Cycle and is responsible for accuracy, completeness, and maintenance of the hospital and professional chargemasters, charge documents, and charge capture processes for the Health System. This position reports to the Senior Director of Revenue Cycle.

Assists with ensuring that accurate and timely charge capture methodologies are in place and executed for the assigned work unit—ensuring they are consistent (in terms of standardization) across pertinent areas/facilities as appropriate; reconciles charges against source documents to ensure that charges have been captured completely and accurately.

Researches and analyzes billing errors and/or omissions, working with appropriate team members; ensures revisions/corrections are sent to Revenue Cycle and incorporated in processing systems in a timely manner, and that the data flows appropriately between departmental and organizational computer systems; may address routine system interface issues, referring non-routine matters to the proper authority. Identifies training needs of staff engaged in billing data entry and related charge-capture/reconciliation activities to ensure procedures are understood and charges are booked timely, appropriately, accurately, and completely, and are properly documented.  Assists in recommendations for annual chargemaster changes through analysis of current rates in comparison to Medicare and payor fee schedules.  Reviews reimbursement compared to contract rates on an ongoing basis.  Responsible for assisting with chargemaster review projects, as assigned.  Prepares reports and provides departmental summary information to the Revenue Cycle teams which are responsible for ensuring that all charges on a system-wide basis are being captured and charged appropriately and for overall compliance.

Assists interdepartmental teams in troubleshooting accounts that are being held in A/R due to charging/documentation discrepancies.  Completes review of all write-offs and payor denials on an ongoing basis.  Performs related duties as required.  Maintains knowledge of and adherence to the Code of Conduct Standards, confidentiality agreements, and the organization-wide Mission Statement.

High school diploma or equivalent; Associates degree in Finance, Health Administration,Public Health, Business Administration or a related discipline desired. Minimum of at least 2 years’ experience working in healthcare. Charge capture review, denials management, or claims auditing experience desired.