Brief Description

JOB SUMMARY:

Charge Capture Specialist is responsible for Transact denial management, charge hold, RAI resolution and abstraction guidance and/resolution to CARTI and Himagine/Omega coding staff. This role is also responsible for hospital charge entry and/or hospital charge reconciliation. Charge Capture Specialist will review tickets on hold for ABN, verifying that the ABN is signed, current, and relates to the charges on the ticket. Incumbent will process specialty pharmacy tickets coded J9999-PD, updating the code to the appropriate drug as noted in OncoEMR. Charge Capture Specialist will review Unsigned Office Notes report daily, determining whether the MD has signed and finalized their documentation, and notifying MD of any outstanding tickets awaiting signature. Incumbent may also be assigned ad hoc projects periodically, based on business office needs.

Requirements

EDUCATION, CERTIFICATION, LICENSURE, REGISTRATION:

Education/Training – High School diploma or equivalent.

EXPERIENCE, KNOWLEDGE, SKILLS And ABILITIES

Business Experience –3 to 5 years medical business office including billing systems, medical coding, and claims submission.
Specialized Knowledge/Skills – Good communication skills. Proficient with Excel and MS office products.

Summary

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Participate in continuing education/training activities including monthly online training.
Maintain a clean, neat, and safe environment for patients and staff.
Ensure that supplies and equipment are stored in an organized and efficient manner.
Demonstrate correct and safe technique in the use of equipment according to specific product information.
Follow appropriate procedure for obtaining and returning or cleaning/disposing of equipment and supplies.
Participate in economical utilization of supplies and ensure equipment is maintained in a clean and safe manner.
Assist patients, family members or other clients with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.
Answer and refer telephone calls or other inquiries to ensure accurate and timely communications are facilitated.
Identify yourself in a pleasant and positive manner.
Take responsibility for helping the caller.
Assist in the orientation/training for new team members.
Assist other team members in the performance of their assignments.
Seek out opportunities to help rather than waiting to be asked.
Consider the impact of your actions on team members throughout CARTI.
Take directions and initiate actions (cross/additional training) that will allow the assumption of cross-functional duties to ensure seamless workflow.
Demonstrate flexibility to perform duties wherever deemed necessary.
Demonstrate ability to handle emergency situations in a prompt, precise and professional manner.
Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns.
Investigate and follow through on unusual orders or requests for service or information.
Follow proper reporting procedures for actual or potential accidents and/or incidents so follow up and/or prevention can occur.
Record/report the need for service maintenance or repair of equipment and remove any faulty equipment from service.
Consistently evaluate work and determine if further steps are needed to meet client expectations.
Take initiative to do to redo inadequate or incomplete work, even if it is not yours.
Ensure compliance with regulatory standards.
Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
Minimize non-productive time and fill slow periods with activities that will enable you to prepare to meet the future needs of the company (education, organizing, housekeeping, assisting others).
Organize job functions and work area to be able to effectively complete varied assignments within established time frames.
Consistently demonstrate ability to take the initiative to make decisions/choices without direct supervision.
Adhere to Administrative and departmental policies.
Ensure that the company is operated in an efficient and cost effective manner by adhering to CARTI attendance policies as documented in the division’s Attendance Policy.
Demonstrate regular attendance and timeliness.
Do not incur excessive overtime.
Remain conscientious in regard to personal hygiene.
Demonstrate adherence to the company Dress Code Policy
Comply with policies and procedures concerning safety.
Comply with the company’s infection control policies and procedures including Body Substance Isolation (BSI) and the Exposure Control Plan which reflects OSHA Blood borne Pathogens Standard to ensure a safe working environment for self and others.
Demonstrate knowledge and understanding of all policies and procedures and ability to reference them from appropriate sources.
Demonstrate adherence and support of company-wide service standards as evidenced by observation and feedback from patients, family members, and other clients.

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Charge Capture Specialist