Sign upLog in

Charge Review Specialist

ECLARO

Chicago, IL

Apply
JOB DETAILS
SALARY
$43.33–$43.33 Per Hour
SKILLS
Analysis Skills, Billing, Centers for Medicare and Medicaid Services (CMS), Charge Capture, Communication Skills, Content Management Systems (CMS), Current Procedural Terminology (CPT), Dental Insurance, Detail Oriented, Diversity, Epic Certification, Fee Schedule, Genetics, Healthcare, Healthcare Common Procedure Coding System (HCPCS), Healthcare Providers, Healthcare Software, High School Diploma, Hospital Administration, Information Technology & Information Systems, Interpersonal Skills, Maintain Compliance, Medicaid, Medical Billing, Medical Coding, Medical Record System, Medical Terminology, Medicare, Microsoft Access Database, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Multitasking, Network Routers, Organizational Skills, Policy Implementation, Presentation/Verbal Skills, Pricing, Problem Solving Skills, Product Pricing, Project Tracking, R Programming Language, Regulations, Regulatory Compliance, Reimbursement, Revenue Analysis, Schedule Development, Team Player, Technical Leadership, Testing, Time Management, Vendor/Supplier Planning, Vision Plan, Writing Skills
LOCATION
Chicago, IL
POSTED
Today
Charge Review Specialist
Job Number: 26-00965

Progress on your journey to success! ECLARO is currently recruiting for a Charge Review Specialist in the Chicago, IL area for one of our clients.

ECLARO’s client is a leading provider of healthcare workforce software and solutions. If you’re up to the challenge, then take a chance at this rewarding opportunity!

Position Overview:
  • The Revenue Integrity CDM Analyst is responsible for the continual maintenance, compliance, and integrity of the Hospital Billing (HB) and Professional Billing (PB) Charge Description Master (CDM), along with related charge review edits and router work queue logic.
  • Job duties consist of researching current and upcoming applicable regulations and implementing all necessary revisions for optimal revenue preservation, prevention of resource leakage, and compliant billing.
  • Responsibilities include analyzing and configuring charge capture workflows, managing technical charging requests, and the coordination of research, training, and communication with hospital administrators affected.
  • The position collaborates with external pricing vendors to manage and execute the implementation of both facility pricing architecture and professional fee schedules, ensuring accurate CPT / HCPCS and revenue code compatibility for accurate billing detail and compliance regulations.
  • The position requires the continual update of all CDM related policies and procedures as necessary.
  • Exemplifies the Client mission, vision and values and will act in accordance with client policies and procedures.

Responsibilities:
  • Maintains all CDM requests across both Hospital Billing (HB) and Professional Billing (PB) structures for charge code additions, revisions, and deletions.
  • Continuously monitors, tracks, and resolves Epic charge review Work Queues (WQs) and billing exceptions to minimize claim delays and decrease Days in A / R.
  • Coordinates with Information Systems to build, test, and implement approved charge codes within the EHR, ensuring seamless integration with Charge Router logic and clinical workflows.
  • Thoroughly analyzes each request for accurate pricing alignment based on vendor strategy tables, established fee schedules, CPT / HCPCS, and revenue code compatibility.
  • Researches current and future complex Medicare, Medicaid, and commercial payer regulations to ensure optimal revenue preservation, prevent resource leakage, and maintain absolute billing compliance.
  • Implements innovative strategies, procedures, and systems to maximize time efficiency and team productivity.
  • Maintains a commitment to continuous professional development and ongoing education in coding, compliance, and revenue integrity.
  • Executes data-driven revenue integrity initiatives and strategic special projects.
  • Leads and coordinates project-based revenue cycle initiatives, ensuring strategic pricing updates, fee schedule restructures, and regulatory compliance changes are accurately modeled, tracked, and integrated into the CDM.
  • Contributes to organizational success by executing additional revenue cycle initiatives and related duties as needed.

Required Qualifications:
  • With an Associate's Degree or Higher:
    • A minimum of five (5) years of direct, dedicated CDM maintenance experience.
    • A minimum of seven (7) years of general healthcare revenue cycle experience (such as Revenue Integrity, Medical Coding, or Billing).
  • With a High School Diploma / GED:
    • A minimum of eight (8) years of direct, dedicated CDM maintenance experience.
    • A minimum of ten (10) years of general healthcare revenue cycle experience (such as Revenue Integrity, Medical Coding or Billing).
  • Advanced knowledge of:
    • Medical Terminology
    • Medical Billing and Reimbursement Methodologies
    • UB-04 Revenue Codes
    • CPT and HCPCS Level II Coding Systems
    • Applicable Coding Modifiers
    • Epic CDM Experience
    • Epic Hospital Billing Certification
    • Current AAPC or AHIMA Certification
  • Proven ability to organize and track project-type work.
  • Working knowledge of CMS / HCFA regulations, payer guidelines, and revenue cycle compliance standards.
  • Strong analytical, problem-solving, and critical thinking skills.
  • Excellent written and verbal communication skills.
  • Demonstrated attention to detail and high degree of accuracy.
  • Strong organizational and interpersonal skills with the ability to collaborate effectively across departments.
  • Strong time management skills with the ability to manage multiple priorities in a fast-paced environment.
  • Proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and Access.

Shift: Day 5x8-Hour (07:00 - 15:30); Duration: 26 weeks

Pay Rate: $43.33 / Hour

If hired, you will enjoy the following ECLARO Benefits:
  • 401k Retirement Savings Plan administered by Merrill Lynch
  • Commuter Check Pretax Commuter Benefits
  • Eligibility to purchase Medical, Dental & Vision Insurance through ECLARO

If interested, you may contact:
Sofia Dela Torre
Sofia.DelaTorre@eclaro.com
(332) 206-0779
LinkedIn | Sofia Dela Torre

Equal Opportunity Employer: ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.

About the Company

E

ECLARO

Eclaro is a Business and Technology Consulting Firm that connects top talent with opportunities nationwide. We have direct access to Hiring Managers from leading Fortune 1000 organizations in almost every industry segment, with particular expertise in:

• Technology and Business Consulting
• Financial Services and Insurance
• Pharmaceuticals and Life Sciences
• Consumer Products, Public Sector, and Utilities

Eclaro provides fully customizable, comprehensive talent acquisition and management of seasoned professionals through a number of business models, including:

• Consulting
• Professional Hiring
• Global Integrated Delivery™
• Managed Services

Eclaro recruits and manages a staff of highly skilled individuals in an array of specialized disciplines enabling our clients to leverage new opportunities, respond to increased and changing demands, and increase their profitability.

Eclaro’s Management Team averages over 25 years of experience in partnering with clients in technical, corporate operations and human capital solutions. We hold ISO 9001:2008 certification and have achieved SOC 2 Type 2 certification in Security, Availability and Confidentiality. Eclaro’s decades of expertise and collaborative practice have proven that The Right People are The Answer.

COMPANY SIZE
500 to 999 employees
INDUSTRY
Staffing/Employment Agencies
FOUNDED
1999
WEBSITE
http://www.eclaroit.com