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Charge Audit Specialist (BGC)

Job Category:

BPO / KPO / Shared Services

Job Level:

Professional

Open Date:

29-Apr-2020

Location:

TAGUIG CITY

Close date:

30-Jun-2020

Client Industry:

SHARED SERVICES

Job Description and Qualification:

  • Responsible for ensuring that all appropriate billing charges are being captured, documented, charged and reimbursed for the assigned department in accordance with policies and procedures, and applicable regulatory standards and requirements. They will also plan, conduct and evaluates reviews and audits of clinical documentation and billing practices for conformity with applicable regulatory requirements.
  • Conducts reviews/audits to identify potential charging and billing issues including lost revenue opportunities; prepares reports based on findings, and provides summary of findings to impacted partners
  • Identifies, researches and analyzes charging and billing errors and/or omissions, working with appropriate staff/team members; ensures that revisions/corrections forwarded and incorporated in processing systems in timely manner
  • Stays current with CMS, AHA and state coding/charging and reimbursement guidelines – training and on the job coaching will be provided
  • Responsible for ensuring that all appropriate billing charges are captured, documented, charged and reimbursed; and working with the billing department to rectify any identified discrepancies
  • Other duties as assigned to meet client expectations that would include root cause analysis, research of complex charging issues, implementation of corrective actions and provide subject matter expertise during system upgrades and implementations

Qualifications:

  • Bachelor’s Degree Holder (Medical-related course/degree is preferred, but if not as long as with experience with the job any course/degree will do)
  • At least 3 years of experience in Healthcare with previous clinical experience
  • Charge review, bill review, or navigating medical records to identify supporting documents such as: MD orders, nursing notes, and ancillary documents
  • A general understanding of charge capture/coding concepts such as: CPT coding, modifiers, and UB revenue codes.
  • Candidates with experience in Charge Audit, Medical coding and Electronic medical records are welcome to apply
  • Amenable to work in BGC
  • Willing to work in a night shift schedule

Salary:

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