UF Health

Compensation

Full Description

Overview Monday through Friday 8:00 AM TO 5:00 PM The Charge Audit Specialist has responsibility to perform charge capture audits, initiate and lead performance improvement efforts to enhance charge capture, educate clinical departments and promote revenue cycle integrity. Responsibilities • Perform charge capture audits by comparing the medical record documentation against the itemized bill. • Identify charging, coding or clinical documentation issues and work with ancillary departments to resolve issues and notify appropriate leadership. • Prepare modifications to patient charges as a result of the audits and as required to ensure appropriate revenue integrity. • Respond to RAC and other third-party payer audit requests in collaboration with Health Information Management and Patient Financial Services. • Maintain an audit activity report to track and communicate audit activity with the associated financial impact. Analyze audit results to identify patterns, trends, variances and opportunities to improve revenue integrity. • Initiate and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance charge capture and promote revenue cycle integrity. • Provide education to all clinical departments as needed to promote appropriate charge capture processes and improve understanding of the documentation requirements for specific charge activity. • Function as a resource to the CDM Coordinator when clinical information is needed to appropriately maintain the Charge Description Master. • Analyze and resolve patient claims being held by billing edits (i.e. NCCI/modifier 59, Medical necessity, Correct coding Initiative, Outpatient Code Editor (OCE), Inpatient Code Editor, Self-Administered and other claims requiring clinical expertise’s). • Compare UB04 charges to BAR charges and ensure all discrepancies are appropriate. • Performs all other duties as assigned by management within job scope. Qualifications Education / Training • High School Diploma/Equivalent Experience • 2-years Medical Coding Preferences: 3-4 years of experience; charge audit or finance related experience. Experience in coding and /or reimbursement. Certificates/Licenses/Registration • Active coding certification from AAPC or AHIMA Preferences: Certified Professional Coder (CPC) Additional Information: Certified Professional Coder (CPC) required within 1 year of hire.