Charge Correction Specialist/Floater

Full Time Charge Correction Specialist/Floater needed for North OKC medical billing office

The Charge Correction Specialist/Floater is responsible for reviewing, logging and correcting all charge errors and claim submission errors related to professional accounts. They are also responsible for the upkeep of the system master files related to billing including requests to add new physicians and insurance companies. As needed they will act as backup for the professional biller and appeals/denial team.

2. Essential Functions: (3-5 core functions-75% of time spent)

• Must possess effective and efficient communication, computer, phone and Microsoft Office skills.
• Must be able to interpret various charge correction requests, determine their validity and perform necessary actions.
• Responsible for completing any and all required actions to correct charge/claim issues so that claims can be re-filed and processed correctly by the payors.
• Must be able to recognize and address claim issues encountered through AR billing system and billing scrubber system.
• Must maintain a positive working relationship with any and all entities they may come in contact with on a daily basis. This includes, but not limited to, clients, physician office staff, physicians, payors, co-workers, management and customers.
• Must be able to handle stressful situations, multi-task a variety of responsibilities and work under strict timelines.
• Employee is expected to be proficient in all systems, programs and processes associated with their current position within the CBO.
• Responsible for the upkeep of billing master files in current billing systems. These duties include, but not limited to, adding of new information per requests received, updating new addresses and other information as it changes, maintenance of NDC numbers, maintenance of TSPID numbers and the addition of new charge/procedure/CPT codes.
• Expected to stay up to date on claim/billing and insurance regulations to ensure our claims are filed correctly as to not delay or reduce reimbursement.
• Effectively working and cooperating with supervisors, co-workers and clients.
• Following the directions of supervisors.
• Refraining from causing or contributing to disruption in the workplace.
• Regular and Reliable attendance.
• Performs other duties as assigned.

3. Functional Accountabilities:

• Identifies all charge entry errors through electronic claims submission rejections, return reports and denials.
• Researches and identifies the charge entry errors and makes all necessary corrections to resolve the issue.
• Receives charge entry correction requests from client offices and performs necessary research to verify the requested correction as valid.  After verified makes all necessary corrections to claim.
• Responds to client requests within 1 business day to advise correction completed or communicates expected turn around time if completion will take longer.
• Re-files claims after corrections have been completed.
• Works all claim rejections received by resolving all issues and re-filing corrected claim.
• Completes requests for master file revisions received from clients, physician/staff, team members and management.
• Reviews master files to make sure their set up is complete and all the information is correct as entered.
• Maintains NDC numbers in current billing system and adds new ones as they are received.
• Maintains TSPID numbers in current billing system and adds new ones as they are received.
• Tracks errors by doctor/client, error type and correction made so that this information can be reported to management for training of appropriate staff.
• Establishes and maintains a professional working relationship with all clinics/staff in all manners of communication.
• Acts as back-up biller and performs all billing functions as needed.
• Assist manager and team lead with special projects and/or reports created for clients/staff.
• Performs back up support for denial management team as instructed by management.
• Stays up to date on billing/claim regulations to ensure claims filed by the CBO are correct and meet all established criteria/guidelines.
• Obtains required approval for corrections made if needed per CBO policy.
• Makes sure all required logs/reports are completed as assigned.
• Works assigned accounts to completion daily.
• Familiar with each client and any special handling required for their particular billing.
• Reports all trends indentified through researching errors so that they may be addressed and corrected to reduce delays in claim processing.

4. Accountability:

Reports to: Coding & Claims Management Manager – Professional team.

Supervises: None

5. Qualifications:  (Minimum education, training and experience, licensure, certification)

• High School Diploma or equivalent; 2 years college preferred
• Minimum 3 years experience in medical business office operations
• EPIC and Allscripts billing system experience preferred

6. Required Physical Demands:    

• Strength (Lift, Carry, Push, Pull):  Sedentary  (exerting up to 10 pounds of force occasionally)
• Standing/Walking: Occasionally; activity exists up to 1/3 of the time
• Keyboard/Dexterity: Constantly; activity exists 2/3 or more of the time.
• Talking (Must be able to effectively communicate verbally): Yes
• Seeing: Yes
• Hearing: Yes
• Color Acuity: No

7. Environmental Conditions:       

          Level:  Low __x__  Moderate ____  High ____ (Exposure to hazardous risks, work environment conditions)

What We Offer

As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes:

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short- and long-term disability
• Flexible financial benefits including FSAs, HSAs, and Daycare FSA.
• 401(k) and access to retirement planning
• Employee Assistance Program (EAP)
• Paid holidays and vacation