Charge Specialist Senior Laboratory Job in Burlington, Vermont

Charge Specialist Senior

The University of Vermont Medical Center

Burlington, VT

The University of Vermont Medical Center is seeking a Charge Specialist Senior to join their team in Burlington, VT. The Charge Specialist Senior is expected to use their AAPC certification and knowledge base to monitor and review all aspects of technical charges in the laboratory work queues to ensure that we maximize reimbursement based on the most appropriate procedural and diagnosis codes. They function independently and as part of a team that corrects billing errors or omissions that then allow for clean claims to be billed to third party commercial and federal insurance carriers.

The Senior Charge Specialist reviews individual patient accounts in laboratory workqueues in the Epic HB module. They are reviewing charges pre-billing that lack a covering diagnosis code for the laboratory testing performed and hold up claims due to lack of medical necessity per local and national coverage policies. In addition, they also review patient accounts on workqueues that have been denied payment by the insurance carriers to resolve the reason for the denial in consultation with the ordering provider.

Daily duties consist of reviewing orders, collecting charge and diagnostic information, reviewing the accuracy of the charge information, reviewing clinical records for appropriate documentation, investigating questionable coding practices, communicating with providers and office staff, and performing charge corrections and credits. They are also expected to respond to queries from clinicians and peers about diagnosis issues relating to patient accounts.

EDUCATION:

• High school diploma or GED required.
• Medical coding certification by AAPC, or equivalent, is required for this position. Applicants who are currently studying for their certification will be considered based on their experience. In that circumstance, successful completion of coding certification required within 12 months of hire.

EXPERIENCE:

• 4 years’ relevant experience in a medical billing environment, including CPT and ICD coding.
• Minimum 2 years of laboratory experience preferred.