charge capture specialist

EvergreenHealth

<div><p>Wage Range: $33.89 - $54.23 per hour</p><div>
Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.</div><div>
</div><div><b>
Job Summary:</b></div><div>
Responsible for evaluating the effectiveness of coding processes, tracking coding performance over time, and identifying trends and opportunities to positively impact revenue cycle performance across the organization. Supports internal documentation and coding review activities, builds and strengthens relationships with operational department leaders, monitors dashboards, prepares and interprets reports, and recommends process improvements that optimize Epic functionality to management. Acts as subject matter expert on complex professional coding topics. Leads or facilitates process improvement projects for identified areas of improvement. Supports other large scale system implementations and projects with a focus on charge reconciliation and capture.</div><div>
</div><div><b>
Primary Duties:</b></div><ul><li>Analyzes Professional Coding denial data. Identifies trends by performing trend analysis. Prevents future denials by developing and recommending new and innovative methods or solutions to identified issues.</li><li>Analyzes and identifies trends within coding change data. Researches and identifies opportunities for coder education or process automation.
</li><li>Reviews charge capture audit reports to verify appropriate charges are captured.</li><li>Monitors the professional coding WQs to identify patterns/trends and investigate potential issues.</li><li>Develops and monitors PB dashboards, Key Performance Indicators (KPI) data, and coordinates Professional Coding analytics.</li><li>Collaborates with IT to leverage Epic technology to improve efficiency and foster automation within the Professional Coding Department.</li><li>Collaborates with clinical areas, Professional Billing, and IT to develop and implement new coding and charge capture workflows.</li><li>Builds strong relationships and facilitates effective communication with clinical areas and operational leadership.</li><li>Creates and distributes Epic reports to key stakeholders at scheduled intervals.</li><li>Develops presentations, reports, and educational materials that effectively communicate information to support Professional Coding revenue cycle optimization.</li><li>Monitors Epic build for CPT charges to optimize revenue and collaborate across clinical operations, finance, and IT to facilitate resolution.
</li><li>Evaluates annual coding changes to determine Epic build. Works with IT to implement identified changes.</li><li>Performs other duties as assigned.</li></ul><div><br>
<b>
License, Certification, Education or Experience:</b><br>
</div><div><b>
REQUIRED</b> for the position:</div><ul><li>High school diploma or G.E.D</li><li>Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Associate [CCA], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT])</li><li>3 years of professional coding experience in a multi-specialty medical group setting.</li><li>Possess advanced skills in Microsoft Office with emphasis on Excel advanced functions and PowerPoint.</li><li>Extensive knowledge in ICD-10, CPT and HCPCS coding for professional services with emphasis on major surgical procedures for multiple specialties.</li><li>Proficient understanding of Epic functionality related to professional coding charge review, denials, and claim edits.</li><li>Proficient knowledge in medical terminology, coding and sequencing guidelines.</li><li>Comprehensive understanding of anatomy, physiology and disease processes.</li><li>Expanded understanding of payer billing requirements, managing denials, payer policies, and navigating payer platforms.</li><li>Excellent written and verbal communication skills.</li></ul><div><br>
</div><div><b>
DESIRED</b> for the position:</div><ul><li>5 years of professional coding experience in a multi-specialty medical group setting.</li><li>AAPC specialty surgical certification(s): Certified Cardiology Coder [CCC], Certified Cardiovascular and Thoracic Surgery Coder [CCVTC], Certified Gastroenterology Coder [CGIC], Certified General Surgery Coder [CGSC], Certified Interventional Radiology Cardiovascular Coder [CIRCC], Certified Obstetrics Gynecology Coder [COBGC], Certified Ophthalmology Coder [COPC], Certified Orthopedic Surgery Coder [COSC], Certified Urology Coder [CUC]).</li><li>Experience with Excel Power Queries</li><li>Experience using Epic SlicerDicer</li></ul><div>
</div><div><b>
Benefit Information:</b></div><div>
Choices that care for you and your family</div><div>
</div><div>
At EvergreenHealth, we appreciate our employees&rsquo; commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being.</div><div>
</div><ul><li>Medical, vision and dental insurance</li><li>On-demand virtual health care</li><li>Health Savings Account</li><li>Flexible Spending Account</li><li>Life and disability insurance</li><li>Retirement plans (457(b) and 401(a) with employer contribution)</li><li>Tuition assistance for undergraduate and graduate degrees</li><li>Federal Public Service Loan Forgiveness program</li><li>Paid Time Off/Vacation</li><li>Extended Illness Bank/Sick Leave</li><li>Paid holidays</li><li>Voluntary hospital indemnity insurance</li><li>Voluntary identity theft protection</li><li>Voluntary legal insurance</li><li>Pay in lieu of benefits premium program</li><li>Free parking</li><li>Commuter benefits</li></ul><div>
</div><div>
View a summary of our total rewards available to you as an EvergreenHealth team member by clicking on the link below.</div><div><div>
EvergreenHealth Benefits Guide</div></div></div>

Professional Coding Analyst

UCLA Health

<div><div><b>Description</b><p></p><p>
Play a key role in safeguarding compliance and optimizing financial performance within UCLA Health. As a Revenue Capture Analyst, you will bring expertise in billing, charge capture, and regulatory standards to ensure accurate, efficient, and compliant revenue practices. This is an opportunity to work collaboratively with clinical, financial, and operational teams while serving as a subject matter expert in revenue cycle compliance and charge capture processes.</p><p>
In this role, you will:</p><ul>
<li>Review and resolve charge capture issues, ensuring accuracy, timeliness, and compliance with CMS, AMA, and internal guidelines</li>
<li>Collaborate with clinical and operational stakeholders to clarify documentation, improve workflows, and prevent revenue loss</li>
<li>Conduct revenue integrity analyses to identify trends, risks, and opportunities for improvement</li>
<li>Support audits, compliance reviews, and policy updates related to charge capture and billing integrity</li>
<li>Provide training and consultative support to departments on charging policies and compliant practices</li>
<li>Develop reports and recommendations to inform leadership on compliance risks and revenue opportunities</li>
<li>Contribute to system enhancements, workflow redesigns, and strategic initiatives to optimize reimbursement</li>
</ul><p><b>
Salary Range:</b> $78,500 &ndash; $163,600 annually</p></div><div><b><br>
Qualifications</b><p></p><p>
We&rsquo;re looking for a detail-oriented and collaborative compliance professional with:</p><ul>
<li>A bachelor&rsquo;s degree in a related area and/or equivalent experience and training</li>
<li>At least five years of revenue cycle, billing, or healthcare financial experience, including CPT/HCPCS coding and billing guidelines (required)</li>
<li>Strong knowledge of hospital revenue cycle functions, including billing, coding, chargemaster management, and revenue integrity</li>
<li>Familiarity with healthcare compliance standards and regulatory requirements (CMS, AMA, etc.)</li>
<li>Advanced analytical and problem-solving skills with the ability to evaluate complex data and recommend solutions</li>
<li>Strong interpersonal and communication skills to collaborate effectively across teams and present findings clearly</li>
<li>Proficiency in Epic (including SlicerDicer), Microsoft Office, and revenue cycle tools such as Optum 360 Charge Assist and Revenue Cycle Pro</li>
<li>Preferred: CCS, CPC-H, CPC certification, or documented evidence of continued coding education</li></ul></div></div>

Revenue Capture Analyst

Trinity Health

<b>Employment Type:</b><br>
Full time
<br><br>
<b>Shift:</b><br>
Day Shift
<br><br>
<b>Description:</b><br>
Purpose
<br>Work Remote Position
<br><b>(Pay Range:</b> $24.5303-$36.7954)
<br>Provides oversight& support of the workflow& functions in accordance with level of experience, education& standards. Assumes an expanded role& increased responsibility including delegating to others. Participates in the development of& the process improvement of policies& procedures. Works closely with leadership to maintain efficient& effective operations to ensure quality in daily operations.
<br>May partner with leadership with the selection, orientation& performance feedback of the team. Works cooperatively to ensure that key customer needs are being met& achievement of operational& performance goals.
<br><b>Note:</b> “patients” refers to patients, clients, residents, participants, customers, members
<br>Essential Functions
<br><b>Our Trinity Health Culture:</b> Knows, understands, incorporates& demonstrates our Trinity Health Mission, Values, Vision, Actions& Promise in behaviors, practices& decisions.
<br><br>
<b>Work Focus:</b><br>
Coordinates operational, technical& / or clerical support services that enhance or improve coordination, preparation& flow of the department process& core work.
<br>Plans& organizes workflows& prioritizes customers’ needs.
<br>May lead a small team; serves as a mentor.
<br>Creates& maintain procedural standards& records as appropriate for role.
<br>Develops& maintains educational programs for the team members, including new employee orientation.
<br><br>
<b>Process Focus:</b><br>
Utilizes multiple system applications for data collection& management.
<br>Incorporates basic knowledge of Trinity Health policies, practices& processes to ensure quality, confidentiality& safety are prioritized.
<br>Demonstrates knowledge of departmental processes& procedures& ability to readily acquire new knowledge.
<br>Collaborate on performance improvement activities as indicated by outcomes in program efficiency& patient experience.
<br>Helps to identify opportunities, develop solutions& lead the team through resolution.
<br><br>
<b>Communication:</b><br>
Employs effective& respectful written, verbal& nonverbal communications;
<br>Develops an environment of mutual confidence& trust through collaborative relationships;
<br>Effectively communicates goals, standards, program expectations, service performance& how the work serves Trinity Health objectives;
<br>Proactively recognizes, addresses& / or escalates organizational, operational& / or team conflicts.
<br><br>
<b>Environment:</b><br>
Performs work in a caring, collaborative& safe manner that complies with regulatory standards.
<br>Maintains a safe, functional& organized workspace environment.
<br>Stewards productive use of resources (e.g., people, financial, equipment, supplies, materials) to achieve assigned commitments, experiences& quality standards.
<br>Accountable for continuous role-based self-development& leadership growth.
<br>Supports the professional growth of team members. Self-monitors& initiates corrections& / or seeks assistance& / or guidance when needed.
<br>Maintains a Working Knowledge of applicable federal, state& local laws / regulations, Trinity Health Integrity& Compliance Program& Code of Conduct, as well as other policies, procedures& guidelines in order to ensure adherence in a manner that reflects honest, ethical& professional behavior& safe work practices.
<br><br>
Functional Role (not inclusive of titles or advancement career progression)
<br>Responsible for ensuring accurate CPT/HCPCS documentation for the patient billing process and educating colleagues and ancillary departments in accurately documenting services performed and using the appropriate codes representing those services.
<br>Responsible for charge capture in Revenue Integrity assigned areas.
<br>Review's chart, including nursing notes, physician orders, progress notes, and surgical or specialty notes thoroughly to interpret and validate and/or extract all charges.
<br>Verifies charges captured on the correct patient, correct encounter, correct date of service, with any required modifiers.
<br>Review's documentation, abstracts data and ensure charges/coding are in alignment within AMA and Medicare coding guidelines.
<br>Performs coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review
<br>Responsible for working the pre-bill edits within key metrics, including but not limited to OCE/CCI,& DNFB.
<br>Provides “at-elbow support” to ancillary departments including but not limited to; ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.
<br>Performs charge entry, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity.
<br>Responsible for coding and/or validation of charges for more complex service lines, advanced proficiencies in surgical or specialty coding practice.
<br>Educates clinical staff on need for accurate and complete documentation to ensure revenue optimization and integrity.
<br><br>
Minimum Qualifications
<br>Associate’s degree in healthcare, business administration, finance, accounting, or related field or equivalent experience considered in lieu of degree.
<br>Minimum three (3) years of relevant coding and charge control work experience in a hospital and/or Physician Practice environment and experience in revenue cycle, billing, coding, and/or patient financial services.
<br>Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes& modifiers), charging processes& audits,& clinical billing
<br>Working knowledge of third-party payer rules& requirements, computer operations& electronic interfaces related to charge documentation, capture& billing is required.
<br>Knowledge of charge capture, reconciliation, error management operations& overall revenue cycle operations required.
<br>Additional Qualifications (nice to have)
<br>Registered Nurse, strongly preferred
<br>Knowledge of Ambulatory Payment Classification (APC),& Outpatient Prospective Payment System (OPPS) reimbursement structures& prebill edits including Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits& Discharged Note Final Billed (DNFB).
<br>Knowledge of clinical documentation improvement processes strongly preferred
<br>Physical& Mental Requirements& Working Conditions (General Summary)
<br><br>
Direct Healthcare Services / Indirect Healthcare / Support Services:
<br><br>
<ul>
<li>Exposure to conditions which may be considered unpleasant to sight, touch, sound& / or smell.Occasional</li>
<li>Exposure to fumes, odors, dusts, mists& gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional</li>
<li>Exposure to or subject to noise, infectious waste, diseases& conditions. Occasional</li>
<li>Exposure to interruptions, shifting priorities& stressful situations. Frequent</li>
<li>Ability to follow tasks through to completion, understand& relate to complex ideas / concepts, remember multiple tasks& regimens over long periods of time& work on concurrent tasks / projects. Frequent</li>
<li>Ability to read small print, hear sounds& voice / speech patterns, give / receive instructions& other verbal communications (in-person& / or over the phone / computer / device / equipment assigned) with some background noise. Frequent</li>
<li>Perform manual dexterity activities& / or grasping / handling. Frequent</li>
<li>Ability to climb, kneel, crouch& / or operate foot controls. Occasional</li>
<li>Use a computer / other technology. Frequent</li>
<li>Sit with the ability to vary / adjust physical position or activity. Frequent</li>
<li>Maintain a safe working environment& use available personal protective equipment (PPE). Continuous</li>
<li>Comply with Trinity Health’s Code of Conduct, policies, procedures& guidelines. Continuous</li>
<li>Ability to provide assistance in the event of an emergency.Occasional</li>
</ul>
<b>Direct Healthcare Services:</b><br>
<ul>
<li>Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional</li>
<li>Lift a maximum of 30 pounds unassisted. Occasional</li>
<li>Use upper& lower extremities, engage in bending / stooping / reaching& pushing / pulling. Occasional</li>
<li>Work indoors (subject to travel requirements) under temperature-controlled& well-lit conditions.Continuous</li>
<li>Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal& external environmental conditions. Continuous</li>
<li>Perform work that involves physical efforts (e.g., transporting, moving, positioning& / or ambulating patients). Occasional</li>
</ul>
<b>Indirect Healthcare / Support Services:</b><br>
<ul>
<li>Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Frequent</li>
<li>Lift a maximum of 30 pounds unassisted. Occasional</li>
<li>Experience of long periods of walking / standing / stooping / bending / pulling& / or pushing. Occasional</li>
<li>Encounter a clinical / patient facing / hands on interactive work environment. Occasional</li>
<li>Work indoors (subject to travel requirements) under temperature-controlled& well-lit conditions. Continuous</li>
<li>Work outdoors with variable external environmental conditions. Occasional</li>
</ul>
<b>Average Workday Activity:</b> Occasional - O (1% - 33%), Frequent - F (34% - 66%), Continuous - C (67% - 100%)
<br><br>
Our Commitment
<br><br>
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Coordinator, Charge, RIO - (Remote)

Providence

<div><p><b>Description</b></p>
<p>Under the supervision of the EWA/MT Director of Revenue Integrity, this position works closely with department Managers/Directors to develop, implement, and evaluate business processes associated with charge capture and revenue monitoring, ensuring account and claim information contains comprehensive and accurate data to provide for compliant, timely billing and optimal reimbursement for services. Responsible for leading, coordinating, and implementing PSJH Charge Description Master (CDM) updates and changes, and charge capture initiatives and processes to ensure revenue management and protection.</p>
<p>Providence caregivers are not simply valued &ndash; they&rsquo;re invaluable. Join our team at Providence St. Patrick Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.</p>
<p><b>Required Qualifications:</b></p>
<ul><li>Bachelor's Degree in business, healthcare administration or related field or equivalent work experience may be accepted in lieu of degree requirement.</li>
<li>Epic experience</li>
<li>3 years of Hospital work experience.</li>
<li>Advanced experience using spreadsheets.</li>
<li>Background in hospital and practitioner billing procedures.</li>
</ul><p><b>Why Join Providence?</b></p>
<p>Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.</p>
<p><b>About Providence</b></p>
<p>At Providence, our strength lies in Our Promise of &ldquo;Know me, care for me, ease my way.&rdquo; Working at our family of organizations means that regardless of your role, we&rsquo;ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.</p>
<p>Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.</p>
<p>Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.</p>
<p>Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.</p>
<p><b>About the Team</b></p>
<p>Providence has a long-standing tradition of caring for residents in western Montana since the Sisters of Providence arrived in the state in 1864. As one of Montana&rsquo;s largest health care providers, Providence works collaboratively across traditional boundaries to develop patient-centered practices that help make lifelong quality care accessible and affordable.</p>
<p>Our award-winning and comprehensive medical centers include Providence St. Patrick Hospital in Missoula and Providence St. Joseph Medical Center, a critical access hospital in Polson. Our not-for-profit network of services also include physicians, more than 40 clinics, care centers, hospice and home health programs, and other diverse community services.</p>
<p>Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.</p>
<p><b>Requsition ID:</b> 403772
</p><p><b>Company:</b> Providence Jobs
</p><p><b>Job Category:</b> Finance Operations
</p><p><b>Job Function:</b> Finance
</p><p><b>Job Schedule:</b> Full time
</p><p><b>Job Shift:</b> Day
</p><p><b>Career Track:</b> Business Professional
</p><p><b>Department:</b> 3500 MGMT SERVICES MSLA
</p><p><b>Address:</b> MT Missoula 500 W Broadway
</p><p><b>Work Location:</b> St Patrick Hospital-Broadway Bldg-Missoula MT
</p><p><b>Workplace Type:</b> On-site
</p><p><b>Pay Range:</b> $28.71 - $44.57
</p><p>The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.</p></div><p></p>

Revenue Integrity Analyst

Memorial Sloan Kettering Cancer Center

<div><div><div><div><div><div><div><div><p><b>About Us:<br>
</b></p></div></div></div></div></div></div></div><p></p><p>The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe.<br>
</p><p></p><div><div><p><b>Exciting Opportunity at MSK: </b>Revenue Integrity Analyst I &ndash; Radiation Oncology
<br>
<br>
At Memorial Sloan Kettering (MSK), our Revenue Integrity team plays a critical role in ensuring accurate charge capture, compliance, and financial integrity&mdash;directly supporting MSK&rsquo;s mission to end cancer for life. As a <b>Revenue Integrity </b><b>Analyst I </b>, you&rsquo;ll collaborate across clinical and financial teams to strengthen workflows and optimize revenue outcomes.
</p></div><p></p><div><p><b>Role Overview
</b></p></div><p></p><div><ul><li><p>Serve as subject matter expert on charge capture and revenue integrity processes , including Radiation Oncology.
</p></li></ul></div><div><ul><li><p>Manage Charge Description Master (CDM) reviews and ensure ongoing integrity.
</p></li></ul></div><div><ul><li><p>Implement standardized corrective measures to improve charge workflows.
</p></li></ul></div><div><ul><li><p>Analyze coding and billing changes and adjust systems accordingly.
</p></li></ul></div><div><ul><li><p>Support departmental initiatives impacting CDM and compliance.
</p></li></ul></div><div><ul><li><p>Collaborate with revenue operations and budget teams on quarterly and annual coding updates.
</p></li></ul></div><div><ul><li><p>Evaluate Epic work/error queues, perform root cause analysis, and recommend solutions.
</p></li></ul></div><div><ul><li><p>Guide clinical departments on correct charge capture, coding, and billing practices.
</p></li></ul></div><div><ul><li><p>Present findings and recommendations to leadership and governance committees.
</p></li></ul></div><p></p><div><p><b>Key Qualifications
</b></p></div><p></p><div><ul><li><p>Strong knowledge of charge capture, CPT/HCPCS coding, and billing compliance.
</p></li></ul></div><div><ul><li><p>COC, CPC, or AHIMA-CCS certification highly desirable.
</p></li></ul></div><div><ul><li><p>Proven experience collaborating with clinical, financial, and operations teams.
</p></li></ul></div><div><ul><li><p>Familiarity with healthcare revenue cycle operations and regulatory requirements.
</p></li></ul></div><div><ul><li><p>Experience analyzing and optimizing Epic charging workflows.
</p></li></ul></div><div><ul><li><p>Ability to lead charge reconciliation education and training initiatives.
</p></li></ul></div><div><ul><li><p>Demonstrated success in identifying workflow deficiencies and implementing sustainable solutions.
</p></li></ul></div><p></p><div><p><b>Core Skills
</b></p></div></div><div><div><ul><li><p>Proficiency with Microsoft Office
</p></li></ul></div><div><ul><li><p>Epic experience strongly preferred
</p></li></ul></div><div><ul><li><p>Radiation Oncology charge capture knowledge strongly preferred
</p></li></ul></div><div><ul><li><p>Strong analytical skills to evaluate workflows, error queues, and compliance risks.
</p></li></ul></div><div><ul><li><p>Ability to clearly communicate findings and educate diverse stakeholders.<br>
</p></li></ul></div><p></p><div><p><b>Additional Information
</b></p></div><p></p><div><ul><li><p>Schedule: 9:00 AM &ndash; 5:00 PM EST, Monday &ndash; Friday
</p></li></ul></div><div><ul><li><p>Location: Hybrid; Primary remote with on site as needed at 633 Third Avenue, New York, NY
</p></li></ul></div><div><ul><li><p>Reporting To the Director, Revenue Integrity<br>
</p></li></ul></div><p></p><div><p><b>Helpful Links </b>:<br>
</p></div><p></p><div><p>Compensation Philosophy
</p></div><div><p>Benefits<br>
</p></div></div><p></p>Pay Range: $75,500.00 - $116,900.00<br>
<p></p>FSLA Status: Exempt<br>
<p></p><p><b>Closing </b>:
</p><p></p><p>At MSK, we believe in fair, competitive pay that reflects your job, experience, and skills.
</p><p></p><p>MSK is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sexual orientation, national origin, age, religion, creed, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.
</p><p></p><p>Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.</p></div>

Revenue Integrity Analyst I - Radiation Oncology

Rush University Medical Center

<p></p><div><p>Location: Chicago, Illinois</p>
<p>Business Unit: Rush Medical Center</p>
<p>Hospital: Rush University Medical Center</p>
<p>Department: Revenue Cycle Revenue Integrit</p>
<p>Work Type: Full Time (Total FTE between 0. 9 and 1. 0)</p>
<p>Shift: Shift 1</p>
<p>Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM)</p>
<p>Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).</p>
<p>Pay Range: $27.47 - $43.27 per hour<br>
Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush&rsquo;s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.</p>
<p>Summary:<br>
The Revenue Integrity Analyst uses advanced knowledge of coding, CDM, charge capture, and auditing to solve complex charging scenarios, provide education and assistance to operational departments, support fellow team members, and develop processes/procedures to ensure accurate and timely capture of all chargeable procedures. The Revenue Integrity Analyst also provides high-level professional support in working advanced outpatient coding edits as well as auditing charges for service lines with potential missed revenue opportunities. The individual who holds this position exemplifies the Rush mission, vision, and values and acts in accordance with Rush policies and procedures.</p>
<div>Other information:<br>
Required Job Qualifications:<br>
<ul><li>Associates degree or higher</li><li>Minimum 2-4 years of healthcare experience working with billing, charge entry, charge capture, or CDM</li><li>AAPC Certification or AHIMA Certification, or Epic Software Certification.</li><li>Proficient and functional knowledge of reviewing charges in the Epic EHR.</li><li>Advanced knowledge of medical terminology as well as medical billing language. Must demonstrate a thorough knowledge of UB-04 Revenue Codes, Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II along with modifiers</li><li>Excellent written and oral communication skills along with problem-solving</li><li>Proficiency with MS Office Suite</li><li>High degree of accuracy and ability to collaborate with others</li></ul>
Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.</div>
<div>Responsibilities:<br>
Job Responsibilities:<br>
<ul><li>Use logic-based critical thinking and decision making to accurately enter charges on patient accounts for hospital/facility and professional charges in accordance with CMS and AMA guidelines</li><li>Responsible for accounts within the assigned Epic Account, Charge Review, and Claim Edit Work queues while solving edits related to National Correct Coding Initiatives (NCCI edits), Medically Unlikely Edits (MUE edits) Procedure to Procedure (PTP edits), and Outpatient Coding Edits (OCE edits) in Epic using patient documentation, coding rules, billing guidelines, and proper modifier use in a timely manner</li><li>Assess the Charge Description Master (CDM) and contribute to accurate CDM line items by evaluating revenue codes, descriptions, CPT/HCPCS code and pricing</li><li>Audit and reconcile charges against clinical documentation, code rules and charging methodologies for internal purposes along with external audits
</li><li>Works with external vendors to review charge capture opportunities and documentation to identify missed charges and correct accounts</li><li>Identify trends, analyze to propose and create meaningful solutions, improve processes, create training content, and participate in the education of departments regarding their CDM and missed charges</li><li>Serves as subject matter expert for fellow team members to review questions and assist with resolving accounts</li><li>Meets or exceeds accuracy, quality work, on-time delivery, and productivity standards set by CMS, OIG, and direct manager</li><li>Researches all current and future complex payor requirements for compliant billing, timely payment, and maximum reimbursement</li><li>Provides input and implements process improvement initiatives recognizing revenue enhancement and charge integrity opportunities</li><li>Communicates, observes, and reports on charge entry trends and patterns and provides recommendations for improvement</li><li>Engages in continual education and training in the revenue integrity field and healthcare CDM, charges, auditing, data, and other duties or projects as assigned</li></ul></div>
<p>Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.</p></div>

Fairview Health Services

<div>Responsibilities/Job Description:
<div>
The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient visits, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM, CPT-4, and HCPCs Coding Classification systems. Utilizes an electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Coder 2's also resolves clinical documentation and charge capture discrepancies and provides feedback to providers on the quality of their documentation and charging.
<br>
<br>
<b>Responsibilities</b></div><ul><li>
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards.</li><li>
Actively participates in creating and implementing improvements.</li><li>
Assigns ICD-10, CPT-4, and HCPCs codes to all diagnoses, treatments, and procedures, according to official coding guidelines.</li><li>
Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.</li><li>
Extracts required information from electronic medical record and enters encoder and abstracting system.</li><li>
Follows-up on unabstracted accounts to assure timely billing and reimbursement.</li><li>
Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines.</li><li>
Meets departmental productivity and quality standards</li><li>
Complete projects as assigned.</li><li>
Timely and accurate work</li><li>
Contributes to the process or enablement of collecting expected payment</li><li>
Understands and adheres to Revenue Cycle&rsquo;s Escalation Policy.</li></ul><div><b><br>
Required Qualifications</b></div><ul><li>
Certificate program in Coding or A.A./A.S. in HIM or Certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle)</li><li>
1 year of coding experience</li><li>
Basic knowledge of Windows-based computer software. Epic and Microsoft Teams.</li><li>
Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary.</li><li>
Registered Health Info Admin (RHIA) or</li><li>
Registered Health Info Tech (RHIT) or</li><li>
Certified Coding Specialist (CCS) or</li><li>
Professional Coder Cert (CPC) or</li><li>
Certified Coding Specialist &ndash; Professional (CCS-P) or</li><li>
Professional Coder- Hospital (CPC-H) or</li><li>
Certified Outpatient Coding (COC) or</li><li>
AAPC specialty certifications</li></ul><div><b>
Preferred Qualifications</b></div><ul><li>
B.S./B.A. in HIM</li><li>
2 years of coding experience</li></ul><br>
<div></div>
Qualifications:
<div>
$26.06- $36.79 Hourly</div></div>

Coder 2

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