Charge Review Specialist

Overview

Responsible for performing timely review of charges in the charge review wqs. Verify completeness of the charge information, add and/or update as needed. Research charges for appropriate codes, modifiers and diagnosis codes based on edits within the Epic system. Utilize resources and tools to review and interpret key data elements following company policy for contracted payors.

• Accurately perform actions on the charges in the charge
• review wqs for each patient encounter
• Review, verify and interpret payor edits in the system
• Timely identify, research and resolve issues that may cause
• delays in resolution
• Inform Team Leader on the status of work and unresolved
• issues. Alert Team Leader of backlogs or issues requiring
• immediate attention.
• Identify clinic trends and provide essential reporting functions
• as required
• Perform special projects as assigned by the Team Lead or
• Manager
• Respond and send emails to different levels of management
• within the Business Groups, Clinics, etc. to resolve charge
• issues
• Review and work assigned wq's on a daily basis to make any
• corrections, resolve edits and submit to the payor

Experience Requirements:

2 years Computer experience in medical billing required

2 years Health care experience in medical billing preferred

2 years Medical Billing software required

2 years Experience with online payor tools preferred

Education:

High School Diploma or GED equivalent required Associates preferred

Certificate/Licensure:

Medical Terminology Certificate preferred at time of hire Additional Duties:
Additional duties as assigned may vary.

UFJPI IS AN EQUAL OPPORTUNITY EMPLOYER AND DRUG FREE WORKPLACE