PB Charge Capture Auditor

at MaineHealth in Scarborough, Maine, United States

Job Description

Summary

Position Summary

The PB Charge Capture Auditor promotes the accuracy of charging practices across the organization. This position serves as a liaison between clinical areas and revenue cycle teams to translate billing needs in order to effectively collaborate with practice operations in improving charge capture for their service lines. Regularly audits documentation to identify charging opportunities, recommend improvements, and collaborate with teams to implement changes. Assists with edit resolution, charging policies and procedures, and charge metrics analysis.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

Education: Bachelor's degree strongly preferred or minimum of four (4) years equivalent and related work experience such as coding, billing, revenue integrity, documentation improvement, clinical practice, or medical auditing required.

License/Certifications: CCS, CCA, CPC, CPC-H, or CIRCC credential or Nursing (RN) certification preferred.

Experience: Knowledge of CPT and HCPCS charging guidelines and principles required. Knowledge of CCI, MUE, LCD/NCD edits and Physician reimbursement methodologies strongly preferred.

Strong ability to apply CMS regulations, AMA guidelines, and healthcare regulatory guidance to specific charging situations. The ability to research and analyze this information to provide compliant charging guidance is required.

Epic Systems and professional charging experience strongly preferred.

Preferred 4 years of experience with project coordination skills; time management and organizational skills: ability to multi task and maintain positive attitude in high stress environments.

Computer proficiency in Microsoft Office is required.

Ability to work independently and in a team environment with minimal supervision to meet deadlines and department goals.

Position requires collaborative and strong communication skills to work closely with clinical departments and practices effectively.
Additional Information

MaineHealth was ranked one of America's Best Large Employers in 2022 by Forbes!

MaineHealth is a not-for-profit integrated health system whose vision is, "Working together so our communities are the healthiest in America." MaineHealth consists of nine local health systems, a comprehensive behavioral health care network, diagnostic services, home health agencies, and 1,700 employed clinicians working together through the MaineHealth Medical Group. With approximately 22,000 care team members, MaineHealth provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire. Learn more about our system at

At MaineHealth, we offer benefits that support an individual's needs for today and flexibility to plan for tomorrow. Our packages include health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.

With a career at any of the MaineHealth locations, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the well-being of our communities and care team members. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Join us, and your abilities will be challenged and enhanced as you take your career to a new level.

Additional Information  MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services. Learn more about this system at www.mainehealth.org

MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.