FHC Charge Processor Specialist

The Charge Processor Specialist is responsible for processing charges for various systems within the Family Health Center of Marshfield, Inc. (FHC). The individual assures timely and accurate billing based on knowledge of applicable billing systems, government/commercial payer regulations, coding guidelines and reimbursement policies, and based on the service area hired within, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), current International Classification of Diseases (ICD) or Code on Dental Procedures and Nomenclature (CDT). A high degree of professionalism and accuracy regarding written and verbal communication between internal and external customers is expected.

This position will be remote, however, we can only accept remote workers in Wisconsin, Minnesota, Florida and Arizona.

ESSENTIAL JOB FUNCTIONS

1. Develops and maintains thorough knowledge of government payer policies, internal charge capture systems and pricing guidelines and based on assigned area, CPT, HCPCS, current ICD, modifiers, or CDT.

2. Serves as a resource to providers, clinical operations and other revenue cycle employees for inquires related to charges and the charge processing system to ensure accurate billing for services.

3. Reviews documentation to assure accurate charge capture to detect and correct unbilled services.

4. Responds to questions and researches information to assist in the resolution of charge discrepancies.

5. Reviews documentation to determine possible charging errors and initiates corrections for purposes of insurance reconsideration processes.

6. Identifies internal system problems and forwards to management for review.

7. Assists with processing discounts and credit corrections to resolve billing matters.

8. Regular attendance is required in order to carry out the essential functions of the position.

9. Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.

JOB QUALIFICATIONS

EDUCATION/EXPERIENCE

For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

Minimum Required:

• Two years’ experience in a medical business office, healthcare setting or comparable experience to the area hired within.
• In lieu of experience, will consider participation in a Medical Coding program through Mid-State Technical College (MSTC), American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA).
• High school graduate or equivalent.
• Successful completion of the following courses, per departmental protocol, within one year of hire:
• Dental - Code on Dental Procedures and Nomenclature (CDT), and medical terminology.
• Patient Financial Services (PFS) - Current Procedural Terminology (CPT), healthcare common procedure coding system (HCPCS), current international classification of disease (ICD) and medical terminology.

Preferred/Optional:

• Graduate of a Medical Coding program through Mid-State Technical College (MSTC), American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA).
• Successful completion of the following courses, per departmental protocol, at time of hire:
• Dental - Code on Dental Procedures and Nomenclature (CDT), and medical terminology.
• Patient Financial Services (PFS) - Current Procedural Terminology (CPT), healthcare common procedure coding system (HCPCS), current international classification of disease (ICD) and medical terminology.