Charge Integrity Analyst 1

JOB SUMMARY

The Charge Integrity Analyst I performs duties of moderate complexity, judgment, and scope. The associate is accountable for maintaining a working knowledge of professional and technical charge editing processes.

ESSENTIAL FUNCTIONS OF THE ROLE

• Serves as an internal resource to clinical departments, revenue cycle operations, and other departments as needed to resolve charge errors.

• Accountable for claim edit and Discharged Not Billed (DNB) work queues in the patient accounting system.

• Accountable for professional charge review, claim edits, and follow-up edits in the patient accounting system.

• Maintains current knowledge of all professional and technical charge entry systems in the clinical and hospital billing systems.

• Maintains a basic to moderate knowledge of ordering processes, and how various systems flow for generation of charges for billing.

• Processes compliance audit corrections in the professional and/or technical charge review environment. Will report all potential compliance findings to management.

• Assists in the resolution of billing edits and denials.

• Acts as a liaison between management, billing, HIM, and clinical departments to resolve errors related to professional or technical charge practices.

• Researches clinical documentation in the medical record to validate that charging activity is appropriate. Completes thorough and accurate documentation.

KEY SUCCESS FACTORS

• Working knowledge of hospital systems utilized in revenue cycle functions including registration, charge entry, order entry, and billing.

• Working knowledge of medical terminology.

• Ability to establish and maintain working relationships.

• Ability to communicate effectively and professionally with physicians, both in writing and orally; courtesy; initiative; resourcefulness.

• Excellent customer service skills.

• Proficient with MS Office applications.

• Must be willing to work varying hours according to work requirements, including nights and weekends.

• Proficient typing (35 wpm minimum)/keyboarding skills.

• Ability to multi-task.

BENEFITS

Our competitive benefits package includes the following

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - Less than 1 Year of Experience