at Mercy Health Corporation (Mercyhealth) in Rockford, Illinois, United States
Job Description
Overview
Charge Entry Analyst, Revenue Cycle, Days, 80 Hrs/2 wks
Location: Mercycare Bldg, Janesville, WI OR Rockton Ave Campus, Rockford, IL. Hybrid, flexible work schedule, and remote opportunities available. Mercyhealth does not currently support remote workers with residency in the following states: CA, OH, OR, PA, NJ, NY.
Responsible for ensuring that all Emergency Department billable medical services and supplies are accurately documented and charged based on payor regulations and department policies. Responsible for reviewing charges that are loaded thru an interface, to ensure they are accurate and timely. Coordinate efforts with the certified coders to prevent errors and contact physician offices for resolution.
Responsibilities
Enters facility related ED charges, including facility E&M and injection and infusion charges within the guidelines set by the organization.
Review physician and facility documentation to identify missing charges. Interact directly with physicians and other providers to resolve coding or documentation questions prior to charge entry. Work with the clinical staff on capturing late charges that require charge entry into the billing system and coordinate efforts to resolve any further issues.
Responsible for reviewing and correcting errors/edits related to ED charges. Responsible for working identified work queues in the billing system and EMR.
When charge errors are identified, notify appropriate departments and provide education, as needed.
Reviews reports from the EMR and identifies and resolves discrepancies.
Conducts reviews on individual patient accounts or categories of charges as part of routine compliance audits or as requested by internal department. Reports findings to requestor and conducts any required follow-up.
Makes episode data and charge related corrections in the electronic billing system to ensure accuracy of charges and billing.
May assist with researching coding inquiries with respect to third party insurance claim denials.
Maintain current knowledge of applicable insurance coding and regulations, other legal reporting /compliance requirements, software functionality, and clinic policies and procedures in a rapidly changing environment and maintains related reference material.
Demonstrates a basic understanding of CPT, ICD-10 and HCPCS guidelines, including linking of codes, correct use of modifiers, and global surgery rules.
Education and Experience
High school diploma or equivalent required. Two years of related experience.
Certification/Licensure
Certified Professional Coder (CPC), or related certification preferred.
Special Physical Demands
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee must be able to hear at high and low levels through voice and telephone communications to be able to respond to patients and partners. The employee is frequently required to sit. The employee is occasionally required to stand; walk; climb; or balance and stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. While performing the duties of this job, the employee must have good manual dexterity to operate keyboard and telephone; repetitive finger/wrist movement associated with use of keyboard. Requires exerting 25 to 50 pounds of force occasionally, and lifting up to 10 to 15 pounds frequently.
Culture of Excellence Behavior Expectations
EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans.
