St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Charge Review Specialist is responsible for ensuring accurate and timely revenue capture for physician practices. This includes managing Charge Review and Claim Edit Practice work queues, patient registration, coding diagnoses, insurance verification, and charge entry to maximize reimbursement as a clean paid claim.

JOB DUTIES AND RESPONSIBILITIES:​

• Utilize fundamental billing and coding knowledge to resolve warnings and errors, ensuring accurate and compliant charges, including medical terminology, CPT, ICD-10, modifier application, and insurance registration updates.

• Perform daily charge entry preparation, verifying patient demographics, registering patients, verifying insurances, and coding billed diagnoses.

• Perform daily review of patient status changes and conduct appropriate follow-up with the Central Billing Office (CBO) to ensure accurate billing.

• Identify patients with diagnoses consistent with practice’s PQRI requirements and conduct appropriate research to report cases accurately.

• Release clean charges within 48 hours from all charge review and claim edit work queues.

• Perform daily charge reconciliation for those charges posted by specialists for reconciliation.

• Maintain a high level of competence related to policies of various insurance companies and Epic-related billing functions.

• Ensure compliance with coding guidelines and billing regulations.

• Maintain thorough and accurate documentation of charge entry and review processes.

• Stay updated on changes in coding and billing practices.

• Collaborate with clinical staff to clarify charge information.

• Assist in providing ongoing education to physicians on coding and billing.

• Communicate effectively with the billing team and other stakeholders.

• Participate in quality improvement initiatives to enhance charge capture and review processes.

• Continually analyze current procedures and make recommendations for process improvement.

PHYSICAL AND SENSORY REQUIREMENTS:

Requires sitting for up to eight hours per day. Continually use fingers for typing, writing, and handling documents. Routinely use upper extremities; occasionally lift items up to 10 pounds. Stoop, bend, and reach above shoulder level regularly. Hearing required to be sharp and alert. General, near, and peripheral vision are all required.

EDUCATION:

High school diploma or equivalent required. Associate or bachelor’s degree in a related field preferred.

TRAINING AND EXPERIENCE:

Minimum of 1 year charge entry experience preferred. Working knowledge of CPT, HCPCS, ICD-10, and medical terminology. Epic experience preferred.

Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.