Charge Capture Analyst (Full Time)
Title: Charge Capture Analyst
FTE: 1.0 FTE (40 hours per week)
Schedule: Monday through Friday, 8:00am – 5:00pm
Holiday Rotation: None
Weekend Rotation: None
On Call Requirements: None
The Charge Capture Analyst is responsible for maintaining the integrity of the revenue capture system for Sauk Prairie Healthcare. The primary focus of this position is to develop and maintain an organizational charge reconciliation program. This position will work closely with all areas of the organization to ensure charge reconciliation is completed daily, identify any technical barriers related to charge capture, and complete process improvement projects to ensure timely and accurate charge capture.
Additionally, this position maintains the Charge Description Master (CDM) for Sauk Prairie Healthcare. This includes developing new charge codes along with performing quarterly updates. The Charge Capture Analyst serves as a resource on government and regulatory requirements, to ensure compliant charge build and processes. Performs regular audits related to charge capture departmental issues, assists in responding to charge related denials, and or patient concerns relative to charging.
POSITION TECHNICAL RESPONSIBILITIES
- Meet with departments on a regular basis to audit CDM volumes for each department and reconciles the department-maintained volume statistics to the volumes charged and reflected in the CDM. Provide monthly reporting packages on reconciliation efforts to the Revenue Integrity Supervisor, Revenue Cycle Director, and Chief Financial Officer.
- Perform yearly charge to volume audit for each department yearly.
- Responsible for the oversight of Sauk Prairie Healthcare’s CDM to ensure accurate application of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) code sets.
- Evaluate current charging processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payor requirements.
- Work collaboratively with various organizational leaders on initiatives to resolve charge capture issues, establish and monitor charge reconciliation processes, decrease billing delays and accelerate revenue.
- Compile information and/or prepare reports identifying results of data integrity findings, along with recommendations.
- Monitor daily charge capture and develop processes for departments to recognize revenue daily.
- Facilitate and/or perform a detailed, quarterly review of the chargemaster, which includes identifying codes that have been deleted, added, or replaced; identifying description changes; and ensuring nomenclature reflects the procedures performed.
- Work closely with Revenue Cycle team members (Outpatient and Inpatient CDI, Coding, and Medical Billing Specialists) to support denial avoidance and improve reimbursement for services performed.
- Suggest process improvement activities and monitor performance.
- Provide training and/or documentation to explain CDM or revenue changes as needed.
- Assist Revenue Cycle staff in resolving CDM, charging, and billing issues.
- Conduct relevant research to assist with completing the appeals process and to stay informed on best practices.
- Ensure compliance with state and federal regulations governing patient services and monitors changes in payor reimbursement requirements.
- Other duties as assigned.
- Required: Associates degree in Business or related field
- Preferred: Bachelor’s Degree
- Required: 1 - 3 years of experience in hospital charge capture review, hospital billing, or health information management in a hospital setting.
- Preferred: None
- Required: None
- Preferred: None
- Required: None
- Preferred: Coding Certification
- Competitive health and dental insurance options
- Flexible paid time off to balance work and life
- Retirement plan with immediate vesting and employer match
- Free membership to our state-of-the-art fitness facility
- Generous tuition reimbursement
- Employer provided life and disability insurance
- Free parking at facility
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