Job Details

Pay range: $23.65 - $34.30 per hour, based on experience.

This position is eligible to work remotely in an approved state by St. Charles. Approved states are the following: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin. If you do not reside in an approved state (or are not willing to relocate to one) then we request that you do not apply for this position.

This part-time position comes with a benefits package that includes medical, dental, vision, a 403(b) retirement plan, and Earned Time Off (ETO).

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: Charge Capture Specialist III

REPORTS TO POSITION: Revenue Integrity Leadership

DEPARTMENT: Revenue Integrity Department

DATE LAST REVIEWED: 6/03/2024

OUR VISION: Creating America's healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value.

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity department focuses on charge capture optimization and documentation improvement through collaboration and education. The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver delightful, transparent, and seamless experience to our patients and customers that captures and collects the revenue earned by St. Charles Health System (SCHS) in a quality, efficient and timely manner.

POSITION OVERVIEW: The Charge Capture Specialist III at SCHS is responsible for validating appropriate charge capture in a quality, efficient and timely manner. Services include but are not limited to utilizing research tools and reporting solutions to leadership on complex situations, and complex review of accounts to accurately capture charges for assigned Charge Capture area and other SCHS departments and or cost centers as applicable. Interprets complex medical record documentation to apply calculations and corrects complex charge capture errors based on SCHS charge capture policies and procedures. This position does not directly manage others but may be asked to assist other caregivers with daily work activities, provide education and feedback on the work of others involved, and support mentoring and training of caregivers. This position is required to understand all Charge Capture Specialist I and II position tasks and responsibilities and function at the highest level of the RI (Revenue Integrity) Charge Capture Complexity matrix in all areas for charge capture area assigned. This position serves as the primary representative of the assigned Charge Capture area and is considered a subject matter expert.

ESSENTIAL DUTIES AND FUNCTIONS:

Perform complex level research of internal and external sources for applying billing, medical coding and charging guidelines when CPT code(s) application is required following Payor guidelines, Federal and State regulations, and laws, along with SCHS policies and procedures for appropriate charge capture processes. This includes but is not limited to complex review of payer reimbursement methodologies, understanding of electronic health record functionality, complex case reviews, resolution of claim errors and edits, knowledge of hospital services and ancillary department services, levels of care, and other department workflows.

Read and interpret documents contained within the medical record to calculate accurate charges.

Complete accurate and timely charge finalization.

Attend and may lead applicable meetings as requested by leadership. May be asked to present requested deliverables.

Deliver excellent customer service in a manner that promotes goodwill, is timely, efficient, and accurate when communication between internal/external stakeholders is necessary.

Develop effective relationships among internal/external stakeholders, colleagues, and staff to build trust and support team through change initiatives.

Engage in educational opportunities to advance knowledge in applicable field. Seeks out applicable educational opportunities and presents to leadership for approval.

Report to applicable leadership opportunities for workflow improvements, system inefficiencies or limitations, and present solutions.

Support the vision, mission, and values of the organization in all respects.

Support Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conduct all activities with the highest standards of professionalism and confidentiality. Comply with all applicable laws, regulations, policies, and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

This position may perform additional duties of similar complexity within the organization as required or assigned.

EDUCATION:

Required: High school diploma or GED.

Preferred: Associate or bachelor's degree with a healthcare related focus.

LICENSURE/CERTIFICATION/REGISTRATION:

Required: RHIA, RHIT, CCS-P, CPC, CPMA, CRC, RN, or LPN.

Preferred: Must hold 2 of the following certifications for certification pay: Registered Health Information Technician (RHIT), RHIA, CHRI, CDIP, CPMA, CCA, CBC, CCS, CCS-P, CPC, CPC-H, preferred.

EXPERIENCE:

Required: Five (5) years of Revenue Cycle Charge Capture experience. Other applicable healthcare financial, analytical, or medical billing and coding position may be considered. Four (4) years of Epic or other EHR experience.

Preferred: Over six (6) years' experience in a revenue cycle charge capture role.

ADDITIONAL POSITION INFORMATION/SKILLS/ABILITIES:

Very strong interpersonal and communication skills, very strong analytic and organizational skills, very high level critical thinking and the ability to meet deadlines and provide deliverables to leadership.

High to expert level proficiency and ability in computer applications, including but not limited to electronic medical record(s), MS Office Suite (Word, PowerPoint, Excel, Teams, and Outlook), Windows operating system and Internet.

High to expert level knowledge of medical billing, coding and charge capture including but not limited to CMS billing and medical coding guidelines, Federal and State billing and coding guidelines, and insurance payer reimbursement methodologies.

High to expert level understanding of CPT-4 code assignment, ICD-10-CM, and ICD-10-PCS code assignment.

High level understanding of NCCI and medical necessity edits and payment methodologies.

High to expert level knowledge and usage of internal software research tools relating to modifier and revenue code assignment.

High to expert level ability to problem-solve and high to expert level research skills.

Maintain professional knowledge by attending educational workshops, reviewing professional publications, participating in educational opportunities. Research and present educational opportunities to leadership as applicable to role.

Identify areas of opportunity for creation of new edits to ensure comprehensive and accurate charge capture.

Strong ability to work independently and collaborate with other team members and leaders.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

PHYSICAL REQUIREMENTS:

Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.

Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.

Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.

Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle.

Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.

Exposure to Elemental Factors

Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.

Blood-Borne Pathogen (BBP) Exposure Category

No Risk for Exposure to BBP

Schedule Weekly Hours:
20

Caregiver Type:
Regular

Shift:

Is Exempt Position?
No

Job Family:
SPECIALIST

Scheduled Days of the Week:
Monday-Friday

Shift Start & End Time: