The Charge Review Analyst monitors and reviews clinical charge capture to ensure accurate and compliant billing within a hospital setting. They serve as a liaison between clinical departments, IT, billing, and revenue integrity teams, utilizing Epic EHR systems to oversee workflows, perform training, and resolve charge-related issues. The role requires expertise in healthcare revenue cycle, medical coding, and strong collaboration skills to maintain high standards of charge accuracy and service quality.
POSITION SUMMARY/RESPONSIBILITIES
The Charge Review Analyst is responsible for monitoring charge capture across all clinical charging services lines at UH, serving as the primary point of contact and subject matter expert for assigned clinical charging departments with the expectation of providing the highest level of service to these departments. The Analyst, as part of a team, oversees the charging practices of University Health and maintains direct relationships with clinical department leaders, nursing staff, technologists, IT staff, Billing, Coding, Compliance, CDM, and other Revenue Integrity team members to act as the bridge between clinical, financial, and IT staff working within the Epic environment. This position performs and assists with activities related to department rounding, workflow review, education/training, issue identification, root cause analysis, and system updates needed for complete and accurate clinical department charge entry and ensures department charge review and reconciliation is performed on a daily basis. Furthermore, the Analyst is responsible for ensuring the highest quality service is provided to our “customers”, which includes clinical department leaders, nursing staff, co-workers, hospital administration, and other revenue cycle colleagues. This position is responsible for organizing and scheduling meetings with appropriate personnel as needed to resolve charging-related issues, and to provide prompt responses to issues, concerns, and/or complaints. The Analyst ensures high quality work and productivity in their performance. This position requires strong critical thinking and interpersonal skills, an established track record of working within the Epic EHR system, and a proven understanding of communication, technical, and revenue cycle skills. Ensures work meets the standards of UH Revenue Integrity department.
EDUCATION/EXPERIENCE
Bachelor's Degree in Accounting, Finance, or Healthcare is required. Equivalent technical or clinical experience may be considered in lieu of education. Minimum two (2) years experience with hospital Revenue Integrity, Charge Capture, Nurse Audit, Denials, and/or Clinical Documentation Improvement required. Knowledge of medical terminology and coding required. Experience working within the Epic hospital information systems environment required. Experience with PC applications such as MS Office Suite (Excel, PowerPoint, Word, Access), MedAssets, Hospital Information Systems (Epic, 3M) required. Epic Certification in HB Resolute highly preferred. Experience with payer reimbursement methodologies (Commercial and Government) preferred. Experience with analyzing Medicare fiscal intermediary bulletins and Center for Medicare Services memorandums preferred. Experience participating in a revenue integrity program preferred.
charge review, revenue integrity, healthcare billing, clinical charge capture, Epic EHR, medical coding, hospital revenue cycle, charge reconciliation, root cause analysis, healthcare compliance
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