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Charge Processing Specialist II

Description

Magee-Womens Hospital of UPMC is hiring full-time Charge Processing Specialist II.  This role will work Monday to Friday daylight shift.  The ideal candidate would have surgical services experience.

Purpose:
Ensure Managed Care requirements are met by accessing the referral system and attaching the pre-loaded authorization to the charge being processed. Direct entry of the Managed Care referral into Cadence will be required of the authorization is attached to the charge document upon submission to the Charge processing Department.

Responsibilities:

  • Verify the appropriate Place of Service (POS) code is submitted in relation to the rendered procedure Type of Service (TOS) at the charge entry level based on the payer specific requirements.
  • Coordinate the exchange of information/documentation with other practice plans or ancillary departments.
  • Document and resolve all problem charge vouchers on a daily basis.
  • Assist in the processing of charges which includes Institutional accounts, charge over ride services and payment transfers for cosmetic services.
  • Process charge documents into the Epic system and maintain minimum productivity levels.
  • Perform limited ICD-9 and CPT-4 coding from charge slips, encounter forms, or source documentation.
  • Ensure the charges for bilateral services are processed in accordance with payer specific guidelines.
  • Review coding and charges for accuracy and completeness.
  • Ensure physician charges are applied to the correct account by verifying information indicated on the charge document against the system information.
  • Ensure the appropriate modifier is attached at the charge entry level for Medicare non-covered and limited coverage service and for resident participation.
  • Assist in the processing of charge correction requests, document types of corrections performed in addition to verifying the validity of the requests received.
  • Verify all charge batches entered are processed with the correct revenue location.
  • Balance charges entered at the end of the day, each day.

 

Qualifications

  • High School diploma or equivalent required.
  • 3 years experience in registration, scheduling, insurance verification, and charge and payment posting processes preferred.
  • Strong verbal, telephone, and written correspondence skills.
  • Knowledgeable of medical terminology, cash collection and application, ICD-9/CPT-4 coding, and third party payer billing and reimbursement practices.
  • Ability to effectively problem solves.
  • Prior working experience on personal computers and various office equipment.
  • Experience with Surgical Services is strongly preferred.  
  • Epic knowledge is preferred. 


Licensure, Certifications, and Clearances:

  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct