Charge Entry Specialist - Tuba City Regional Health Care Corporation

Navajo Preference Employment Act :In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act.  Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.Overview:

POSITION SUMMARY

The incumbent performs highly technical and specialized functions by reviewing, analyzing, and charging procedures performed in the clinic setting.  The primary function of this position is to select the appropriate charge codes based on the procedure(s) performed.  The charging function is a primary source for data and information used in health care reimbursement, and promotes provider/patient continuity, and accurate database information. The charging function(s) ensures compliance with established charging guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Qualifications:

NECESSARY QUALIFICATIONS:

Education:

High School Diploma or GED

Certification:

Charge Entry Specialist II:

• Certificate in medical coding

Experience:

Charge Entry Specialist I

• Three (3) months experience with medical coding or charging

Charge Entry Specialist II

• Two (2) years of medical charging experience

Other Skills and Abilties:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers.  All employment references must address and indicate success in each one of the following areas:

• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences
• Positive working relationships with others
• Maintains a positive professional attitude and demonstrates good interpersonal communication skills
• Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing charges, or substantiate listing additional charges in the Sunrise Financial Manager or other electronic system.
• Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC.

 

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an   employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical:

The work is primarily sedentary with the following physical requirements; prolonged ability to sit, stand, walk, drive, maintain balance, reach; and frequent ability to twist.  Must have ability to stoop, bend, kneel, crouch occasionally; and pick up objects from the floor without restrictions, and have full use of hands and arms, i.e., to operate office equipment such as computer, calculator, printer, fax, etc. Must have the ability to utilize hands occasionally in simple grasping, firm grasping, and fine manipulation. Must be able to utilize a keyboard for a prolonged period with repetitive movement of fingers. Position may be exposed to prolonged infectious diseases and possible frequent exposure to chemical agents.

Mental:

Exercise a high degree of judgment and leadership in planning, organizing, staffing, directing, evaluating and business office activities.  Work is reviewed for conformance to policies, procedures, and practices relating to business offices practices. The employee must have the ability to organize, set priorities, develop, and implement solutions, motivate employees, and operate the department according to the constraints of The Joint Commission, budget, and regulatory agencies. Ability to interact between all disciplines within the facility is required. Must be able to frequently cope with high levels of stress, make decisions under high pressure, cope with anger/fear/hostility of others in a calm way; and work in areas that are close and crowed. Incumbent must have prolonged ability to concentrate; handle a high degree of flexibility; handle multiple priorities in stressful situation; work alone; demonstrate high degree of patience; and, adapt to shift work.

Responsibilities:

ESSENTIAL FUNCTIONS:

Charging Specialist I

• Relies on instruction and pre-established guidelines to perform the functions of the job
• Work under immediate supervision or team lead leader

Charging Specialist II

• Relies on limited experience and judgment to plan and accomplish goals and performs a variety of tasks
• Works under general supervision with a certain degree of creativity and latitude

1. Receives and reviews charge documents from the Emergency Department, clinics or inpatient services.
2. Abstracts all necessary information and assigns charge codes, which most accurately describe each documented note, surgical procedure and special therapy or procedure according to established guidelines.
3. Ensures charge information provided is correct and accurate. Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct medical code.
4. Balances Charge Summary to Charge Order Sets or Superbills before updating charges.
5. Keeps supervisor or Lead apprised of matters regarding charge entry including errors and escalations
6. Enters charges in a timely manner in a high volume setting. Minimum expectation is to complete charging for 120 ambulatory visits per day.  Inpatient charging is expected to be within one day of service.