Charge Validation
Review and analyze medical documentation, including patient records, encounter forms, and electronic health records.
Verify the accuracy of CPT, HCPCS, and ICD-10 codes assigned to services and procedures.
Ensure that charges submitted for billing are complete and meet all documentation requirements.
Coding Compliance
Assess coding compliance with federal and state regulations, as well as payer-specific guidelines.
Identify and correct coding errors, discrepancies, and unbundling issues.
Collaborate with coding specialists to resolve coding-related discrepancies.
Charge Accuracy
Validate the appropriateness of charges for services rendered based on medical records.
Confirm that charges match the services provided and the documentation in the patient’s file.
Investigate undercoding and overcoding issues and take corrective action.
Claim Submission
Collaborate with billing specialists to ensure corrected charges are accurately resubmitted.
Prepare and maintain documentation related to charge reviews and corrections.
A/R Follow-up
Monitor and resolve outstanding claims, communicate with payers, and reconcile payments while supporting the clinic’s ability to continue providing quality healthcare services to patients.
Qualifications
- High school diploma or equivalent; certification in medical coding preferred
- Proven experience in charge review, medical billing, or coding
- Proficiency with electronic health record (EHR) systems, billing software, and coding tools
- Strong knowledge of medical terminology, CPT, HCPCS, ICD-10 coding, and compliance regulations
- Detail-oriented with strong analytical and problem-solving skills
- Excellent communication and teamwork abilities
- Familiarity with HIPAA regulations and patient confidentiality
Physical Requirements
- Prolonged periods sitting at a desk and working on a computer
- Ability to lift up to 15 pounds at times
Working Conditions
- Office, laboratory, and/or clinic environment
- Full-time schedule, defined as 40 hours per work week
Location
Atlanta, Georgia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago