Charge Entry, Audit & Denials Specialist Job Listing at Blanchard Valley Health System in Findlay, OH (Job ID 18295)

Description

PURPOSE OF THIS POSITION

Responsible for charge entry, prior authorizations, denial management and follow-up, charge audit, compliance audits and office management activities for departments within Oncology Services.

JOB DUTIES/RESPONSIBILITIES

Duty 1: The charge entry specialist will ensure there is a valid pre-authorization for treatment for every patient.

Duty 2: The charge entry specialist will ensure department charges are entered in a timely fashion not exceeding hospital established guidelines.

Duty 3: The charge entry specialist will be responsible for follow up of all denials as well as keep monthly totals and communicate to supervisor and or director. There will be a timely response to all requests for data to avoid nonpayment.

Duty 4: The charge entry specialist will be responsible for coordination of compliance audits pertaining to charging, documentation etc.

Duty 5: The charge entry specialist will ensure discharge of patient encounters and discharge recurring encounters per policy.

Duty 6: The charge entry specialist will audit charges and follow up with billers and coders as needed to prevent denials for department.

Duty 7: The charge entry specialist will ensure diagnosis is valid for type of service given, referring to Craneware, consultants or coding resources as needed.

Duty 8: The charge entry specialist will keep track of pre-authorization and order dates for expiration.

Duty 9: The charge entry specialist will identify any insurance issues and notify financial advocate to help patients be connected to appropriate assistance.

Duty 10: Other duties as assigned.

REQUIRED QUALIFICATIONS

• High school graduate or GED equivalent.
• Typing, Medical Terminology and charge entry training or experience.
• Data entry and PC experience.
• Positive service-oriented interpersonal and communication skills.
• Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department.
• The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient status. 
• Must be able to interpret the appropriate information needed to identify each patient's requirements relative to their age-specific needs and to provide the care needed as described in the area's policies and procedures.

PREFERRED QUALIFICATIONS

• Associate's degree in related field.
• IDC-10 certification or experience.

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent walking, lifting, bending, climbing, squatting, kneeling, twisting, sitting and standing. This associate will be required to sit for six hours a day. The individual must be able to lift twenty pounds, and reach work above the shoulders. This position requires corrected vision and hearing in the normal range. Individual must have excellent verbal communication and telephone skills to perform daily tasks.