PRIMARY FUNCTION:
The incumbent performs highly technical and specialized functions by reviewing, analyzing, and charging procedures performed in the clinic setting. The primary function of this position is to select the appropriate charge codes based on the procedure(s) performed. The charging function is a primary source for data and information used in health care reimbursement, and promotes provider/patient continuity, and accurate database information. The charging function(s) ensures compliance with established charging guidelines, third party reimbursement policies, regulations and accreditation guidelines.
ESSENTIAL FUNCTIONS:
Charging Specialist I
- Relies on instruction and pre-established guidelines to perform the functions of the job
- Work under immediate supervision or team lead leader
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, which most accurately describe each documented note, surgical procedure and special therapy or procedure according to established guidelines.
- Ensures charge information provided is correct and accurate. Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct medical code.
- Balances Charge Summary to Charge Order Sets or Superbills before updating charges.
- Keeps supervisor or Lead apprised of matters regarding charge entry 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 to be within one day of service.
MENTAL AND PHYSICAL EFFORT
The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Physical:
Prolonged standing, regular reaching, bending stooping, moderate lifting in the performance of assigned duties. May work nights, weekends, and holidays. Manual dexterity, visual acuity, and the ability to speak and hear are required.
Mental:
Must carry out daily duties and project assignments in an independent manner utilizing knowledge and experience of the section time limits, procedures, and objectives to establish individual work priorities. High levels of mental concentration are required.
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NECESSARY QUALIFICATIONS:
Education, Experience, Certification:
Charge Entry Specialist I
- Must have High School Diploma or GED
- Must have at least three (3) months to a year of experience with medical coding or charging
Charge Entry Specialist II
- Must have High School Diploma or GED
- Must have two (2) years of medical charging experience
- Must have a certificate in medical coding
Other Skills and Abilities:
A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:
- Possession of high ethical standards and no history of complaints
- Reliable and dependable; reports to work as scheduled without excessive absences
- Positive working relationships with others
- Maintains a positive professional attitude and demonstrates good interpersonal communication skills
- Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing charges, or substantiate listing additional charges in the Sunrise Financial Manager or other electronic system.
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