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University of Florida Health

Charge Audit Specialist | Ambulatory Revenue Cycle | Full-time

University of Florida Health, Florida, New York, United States

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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.

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