Job Summary

The Charge Integrity Analyst I performs duties of moderate complexity, judgment, and scope. The associate must know professional and technical charge editing processes.

Hybrid position: 

• Candidate must live in the Baylor Scott & White service area (DFW, Temple/Waco, Greater Austin Area, and/or College Station).

Essential Functions of the Role

• Serves as an internal resource to clinical departments, revenue cycle operations, and other departments as needed to resolve charge errors.
• Accountable for claim edit and Discharged Not Billed (DNB) work queues in the patient accounting system.
• Accountable for professional charge review, claim edits, and follow-up edits in the patient accounting system.
• Maintains current knowledge of all professional and technical charge entry systems in the clinical and hospital billing systems.
• Maintains a basic to moderate knowledge of ordering processes, and how various systems flow for generation of charges for billing.
• Processes compliance audit corrections in the professional and/or technical charge review environment. Will report all potential compliance findings to management.
• Assists in the resolution of billing edits and denials.
• Acts as a liaison between management, billing, HIM, and clinical departments. Resolves errors related to professional or technical charge practices.
• Researches clinical documentation in the medical record to validate that charging activity is appropriate. Completes thorough and accurate documentation.

Key Success Factors

• Working knowledge of hospital systems utilized in revenue cycle functions including registration, charge entry, order entry, and billing.
• Working knowledge of medical terminology.
• Ability to establish and maintain working relationships.
• Ability to communicate effectively and professionally with physicians, both in writing and orally; courtesy; initiative; resourcefulness.
• Excellent customer service skills.
• Proficient with MS Office applications.
• Must be willing to work varying hours according to work requirements, including nights and weekends.
• Proficient typing (35 wpm minimum)/keyboarding skills.
• Ability to multi-task.
• Must have revenue cycle experience in a healthcare setting.
• Experience with Epic is required.
• Collections experience
• Front-end and back end revenue cycle knowledge is essential.

• Access service experience is preferred.

   

Belonging Statement

We believe that all people should feel welcomed, valued and supported.