Senior Charge Capture Analyst

🕒 September 29

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 31%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 47 days.
• Jobs at this company usually fill in 21 days.
• No salary listed.

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Prisma Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Prisma Health is a comprehensive health care provider offering a wide range of medical services to ensure individuals achieve their healthiest state. With numerous locations, advanced technology, and expert specialists, Prisma Health provides accessible and convenient care. Services include primary care, specialized heart, cancer, women's, and children's health, as well as same-day and telehealth options. Prisma Health emphasizes community outreach and education to support overall health and wellness.

📋 Description

• Advise departmental revenue owners and staff on proper usage of charge codes using medical record analysis • Review and apply billing guidelines, state and federal regulations, and third-party billing rules and coverage • Identify opportunities to capture additional revenue in accordance with applicable guidelines • Monitor daily charge capture, revenue reconciliation, late charge trending, revenue trending, and work queues • Identify operational trends and benchmarks • Work with Revenue Cycle and IT staff to resolve accounts not routing through the HB Revenue Cycle process • Validate principal and secondary diagnoses, procedures, and CPT/HCPCS codes • Develop data requirements and work with analytics groups on internal charge review audits • Assist the supervisor with coding and billing questions, escalated accounts, and issues • Participate in system conversions, implementations, upgrades, Epic go-live charging hub activities, and the Revenue Management Task Force • Provide coding and reimbursement revenue review for proposed system builds • Work with CDM, clinical departments, and I/S to support Epic and system build for charge entry and capture • Identify and troubleshoot charge issues and enhancement opportunities • Optimize processes so services are accurately reported and reimbursed while maintaining compliance • Review departmental charge capture processes and update documented procedures • Coordinate with department leadership, CDM team, and stakeholders on new procedures, charge setup, and education • Partner with vendors on optimization projects involving data review, auditing, and testing • Perform other duties as assigned

🎯 Requirements

• High School diploma or equivalent or post-high school diploma / highest degree earned • Five (5) years of healthcare revenue cycle experience • In lieu of the stated requirements: Associate degree and four (4) years of healthcare revenue cycle experience, including two (2) years of charge description master/revenue integrity experience • In lieu of the stated requirements: Bachelor's Degree and two (2) years of charge description master/revenue integrity experience • Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS • Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, and revenue cycle processes • Ability to interact with diverse groups at all levels of the organization by providing guidance and education • Ability to understand and apply National and Local Coverage Determination to complete assigned work queues and educate facility departments routinely

🏖️ Benefits

• Full-time employment • Day shift • Remote work indicated in the job title

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