Job Summary

The Corporate Charge Operations Specialist I performs duties of low to moderate complexity, judgment, and scope. This position is responsible for CPT/HCPCS coding and charge functions for various specialties and hospitals by review of clinical documentation. S/he is responsible for the integrity of the charges and CPT/HCPCS coding assignments for optimization of revenue and coding compliance.

Essential Functions
 

Performs  CPT coding of hospital services and verifies that all requisite charge information is entered. Appends limited modifiers, e.g., -24, -25, -59. Codes minor surgical procedures. Assigns Evaluation and Management (E/M) codes. Performs reconciliation process to ensure all charges are captured. Processes automated or manually enters charges into applicable billing system. Researches, answers, and processes all edits associated with claim and coding submission. Processes charges on a timely basis and communicates with team members to be sure department guidelines regarding timeliness are met. Assigns E/M codes from provider documentation.

 

Physical Requirements
 

 

Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications
 

High School Diploma or GED required. CPC, CPC-A or equivalent coding credential required. Some coding, medical billing and/or clinical experience preferred. Maintains coding certification (CPC, CPC-A, CCS, RHIT, RHIA). Annually reviews new and revised CPT and ICD codes. Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Working knowledge of coding, medical terminology, anatomy, and physiology.