Job Title: Charge Entry Specialist
Job Summary:
The Charge Entry Specialist / Certified Medical Biller & Coder is responsible for accurate charge capture, coding review, and claim preparation to ensure timely and compliant reimbursement. This role requires strong attention to detail and the ability to critically evaluate physician documentation, identify missing or inaccurate charges, and resolve billing discrepancies before claims are submitted.
Key Responsibilities:
- Review physician documentation and accurately assign CPT, ICD-10, HCPCS, and modifier coding.
- Enter and verify charges for office visits, procedures, injections, diagnostic services, and durable medical equipment.
- Reconcile charges against schedules, encounters, and operative reports to ensure complete revenue capture.
- Analyze documentation for missing, inconsistent, or billable services that may impact reimbursement.
- Research and resolve charge, coding, claim discrepancies and claim rejections.
- Collaborate with physicians and clinical staff to obtain clarification on documentation when needed.
- Identify trends that may lead to denials, missed charges, or revenue leakage.
- Maintain compliance with payer, Medicare, Medicaid, and HIPAA guidelines.
- Assist patients with billing questions and explain charges and EOBs as appropriate.
- Assist in analyzing denials and help support the appeal process to maximize reimbursement
- Support departmental quality, audit, and process improvement initiatives.
- Requires regular and consistent attendance.
