Responsible for resolving pre-billing edits that prevent clean claim submission. Works to identify root causes, correct charge and modifier issues, and collaborate across departments to reduce reoccurrence.
Key duties include reviewing APC/OCE and MUE edits, re-abstracting encounters as needed, coordinating with pharmacy and HIM, supporting charge capture and AR follow-up, and assisting with patient or insurance carrier communications when required.
Requirements & Qualifications
Required
- High school diploma or equivalent
- 2 years of experience performing charge quality assessment in an acute care hospital
- Proficiency in Microsoft Office, including Word, Outlook, and Excel
- Strong written and verbal communication skills
- Ability to work independently with strong attention to detail
- Knowledge of CPT codes, modifiers, charge capture, APC structure, UB claim forms, and hospital billing structure
- Understanding of coding, billing, reimbursement, documentation, and compliance concerns
- Must be able to read and write in English
- Ability to prioritize workload and demonstrate flexibility
Preferred
- Associate degree
- Bachelor's degree
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago