PO Charge Capture SpecialistII - King's Daughters

• JOB SUMMARY
  • The PO Charge Capture Specialist is responsible for optimal and quality charge entry related to all inpatient and outpatient separately billable services. Will conduct thorough reviews of the medical record to ensure that the clinical documentation supports the capture and billing of charges. Takes an active role in identifying the discrepancies in the provider documentation and will report findings to management for educational purposes.
• DUTIES AND ESSENTIAL FUNCTIONS
  • Overall performance rating of below indicated essential job duties:
  • Is able to identify all significant diagnoses and procedures that affect the encounter.
  • Is able to assess the medical record documentation to assure that it provides the supporting documentation for each and every diagnostic or procedural coded assigned.
  • Required to query/consult with the appropriate provider for clarification of data that is conflicting, ambiguous or requires more specific and detailed information in order for the correct code to be applied. Is required to follow correct query writing guidelines as set forth by compliance policy.
  • Is able to identify previous diagnoses/procedures that no longer apply to the current encounter.
  • Is able to identify signs and symptoms of disease processes to discern when and when not to code signs and symptoms in addition to the main disease.
  • Is knowledgeable to ICD-10-CM, ICD-9-CM composition, instructional notations and conventions in the application of correct diagnostic and surgical codes and shall sequence them correctly.
  • Is knowledgeable to CPT-4 composition, instructional notations and conventions in the application of correct procedural and surgical codes and shall sequence them correctly.
  • Required to maintain a complete knowledge of current and approved ICD-10-CM, 1CD-9- CM/CPT-4 coding guidelines as set forth by "AHA Coding Clinic for lCD­9-CM", "AMA CPT Assistant", "and AHA Coding Clinic for HCPCS", all Medicare transmittals pertaining to correct coding and correctly apply any CCI edits to procedural coding.
  • Is required to be involved in the quality assessment process to assure continuous improvement in ICD-9-CM, ICD-10-CM and CPT-4 code applications and the assurance of the generation of quality health data.
  • Is required to know and follow KDMC's Corporate Compliance Policy.
  • Is proficient in selecting the principal diagnosis in cases where the principal diagnosis is not easily discernable due to the presence of multiple problems and follows current official coding guidelines to correctly assign choice of principal diagnosis.
  • Is knowledgeable in assigning multiple codes to correctly code a condition when needed.
  • Does not maximize reimbursement through fraudulent practices involving the assignment of codes that do not conform to established and approved coding guidelines.
• EDUCATION/LICENSE/ CERTIFICATIONS/OTHER REQUIREMENTS
  • Minimum requirement:
    • High school diploma or general education degree (GED)
    • Medical coding certification from accredited course of education
  • Preferred qualifications:
    • Previous experience and knowledge of insurance billing
    • One year healthcare experience
    • Medical coding certification in more than one area/specialty of charge capture
• WORKING ENVIRONMENT
  • This job operates in a professional office environment routinely using standard office equipment such as computers
  • The noise level in this position is usually low
• PHYSICAL DEMANDS
  • Regularly required to maintain a stationary position behind a computer
  • Regularly required to communicate with callers telephonically and in-person requiring talking and hearing
  • Constantly required to operate a computer and telephone.
  • Occasionally required to lift and/or move up to 25 pounds.
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, and depth perception.

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