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St. Elizabeth Healthcare · 7 hours ago

Analyst Charge Capture

Edgewood, KY

Full-time

Onsite

Entry, Mid Level

2+ years exp

St. Elizabeth Healthcare is a trusted provider of quality care across Kentucky, Indiana, and Ohio. The Analyst Charge Capture position involves reviewing and correcting departmental charges, ensuring accuracy and completeness in claims, and conducting audits to improve compliance and reduce denials.

Health Care

Responsibilities

Conducts reimbursement audits consistent with National Care Billing Audit Guidelines and St. Elizabeths Corporate Compliance Program to determine charge accuracy and deficiencies. Identifies reimbursement gaps and updates charges to include appropriate billing/coding (modifiers) as related to defense audits, charge capture, ABNs, billing edits using manual resources and automated workqueues

Identifies trends and areas of opportunity strategies to reduce charge edits, support appropriate charge capture, reduce third-party payer denials, and improve compliance. Provides Assists in developing comprehensive reporting and analysis

Understands Medicare, Medicaid and commercial/managed care contract payment guidelines (including carve-outs) to support and flag correct reimbursement. Assists in the reviews and follows-up on edits, denials, appeals, and lost claims

Effectively communicates edit/audit/denial findings to the various departments throughout the organization in order to prevent issues or missed opportunities. Provides training and education to staff regarding trends of CMS, NCCI, and AMA changes. Participates in policy/procedure/work plan designs as new audits/edits are uncovered

Adheres to the National Care Billing Audit Guidelines and St. Elizabeths Corporate Compliance Program while performing all duties detailed

Assists with new charge development and CDM support and maintenance

Performs other duties as assigned