Charge Capture Specialist

Charge Capture Specialist

Department:
Revenue Cycle

Program:
Health Systems

Reports To:

Revenue Integrity Supervisor

Employment Status:
Full-Time

FLSA Status:
Non-Exempt

Schedule:

40 Hours/52 Weeks

Preference: TERO Ordinance 2017-01, P.L. 93-638

A Charge Capture Specialist collaborates with all Health Systems Departments to ensure accurate and timely capture of un ina (patient) charges. The role involves reviewing medical records and claims to verify correct billing codes are documented, identifying discrepancies or missing information, and ensuring compliant revenue capture.

• Collaborates with Health Systems staff to enter all un ina (patient) charges into the appropriate electronic health record system accurately, completely, and on time.
• Reviews charges to ensure clinical documentation supports each charge for claims submitted and payments received.
• Uses system reports to verify and reconcile un ina (patient) charge activity.
• Identifies and resolves charge capture errors for all Health Systems Department claims in a timely manner.
• Collaborates with Revenue Cycle team to maintain the charge master.
• Works with Central Billing Office to ensure claims are coded and charges are captured in alignment with best practices.
• Provides training on charge capture compliance to Health Systems Providers in collaboration with Revenue Integrity Supervisor.
• Ensures compliance with Tribal, federal, state, and local employment laws and regulations, Tribal policies and TERO ordinance.

Note:

It is the intent of this job description to highlight essential functions; the incumbent may be required to perform other duties as assigned by the supervisor, consistent with the position’s purpose and the Kenaitze Indian Tribe's objectives.

• Light work:
  Exerting up to 20 pounds of force frequently; occasional or negligible force to move objects.

• Stand or sit in stationary position
• Walk; use hands/fingers to handle or feel
• Talk/hear; see; repetitive motion

• Category III – Normal routine involves no exposure to blood, body fluids, or tissue; no emergency care duties required.

Equipment used for job:
Computer, phone, scanner, copier, electronic health records.

• Local
• In-State

• High School Diploma or GED

• Two (2) years medical charge and billing
• Proficiency in electronic health records

• Knowledge and experience working with cultural diversities
• Associates degree in related field
• Experience with Indian Health Services facilities operations
• At least one of the following certifications: CPC+CPB or BCSC

• Proficiency with Microsoft Suite; ability to obtain training within 90 days of hire
• Service-oriented demeanor with un ina, visitors, co-workers and others
• Ability to multi-task, work independently, and meet deadlines
• Excellent verbal and written communication for collaboration with team members and stakeholders
• Knowledge of healthcare services (Primary Care, Dental, Optometry, Laboratory, Therapy, Radiology, Pharmacy, Behavioral Health)
• Understanding of health care billing practices, coding standards (ICD-10, CPT) and insurance claim processing
• Knowledge of electronic health records
• Familiarity with federal and state healthcare billing regulations and HIPAA compliance
• Knowledge of HCPCS guidelines
• Ability to perform reporting, reconciliation, and data analysis
• General understanding of modifiers and medical terminology

This position is a Covered Position subject to the Alaska Barrier Crimes Act (ABCA) and the Indian Child Protection and Family Violence Prevention Act (ICPA); ABCA/ICPA requirements apply at all times to remain in the position.

Memorandum of Understanding: Serves as documented evidence that the Kenaitze Indian Tribe has expressed the ineligibility of an employee to operate tribal vehicles or operate a personal vehicle on behalf of the Kenaitze Indian Tribe.