Charge Management Specialist at Tennessee Retina MSO LLC in Nashville, Tennessee

Job Description:

Who We Are
Tennessee Retina is the largest Ophthalmology practice in middle Tennessee offering rewarding careers across 8 locations. We are committed to providing the highest level of care to our patients in the most convenient and caring manner. Our physicians are leaders in the research and application of new retina, macula, and vitreous treatments.

We are seeking an energetic and collaborative Charge Management Specialist. The Charge Management Specialist is responsible for charge capture and review functions within the Billing Office.

This exciting opportunity will work closely and be supported by a team of colleagues, strong leadership, and cutting-edge technology! A day in the life of a Tennessee Retina employee is filled with learning, growing, creating, hard work, and, most of all, fun!

Tennessee Retina offers a competitive salary based on diverse experiences and backgrounds.

Benefits Offered

Sign On Bonus, Certification Incentive Bonus, and Length of Service Award Bonus Programs
Continuing Education Program
Transportation Reimbursement Program
Employer-sponsored Medical, Dental, Vision, Critical Illness Coverage, Short-term, Long-Term Disability, & Employee Assistance Program
401(k) with Generous Employer Match
Health Savings Account (HAS) and Flexible Spending Benefits
Paid Holidays and Paid Vacation
Annual Scrub Uniform Allowance
Employee Referral Award Bonus Program
Succession, Growth, and Mentorship Opportunities

Social Gathering and Team Opportunities
Full new hire training program to fully support, train, and welcome new hires to the team

Responsibilities

Obtains electronic charge files from the practice electronic health records system interface and paper charge tickets from TNR providers seeing patients at remote facilities. Enter charge data into the practice management system for pre-bill scrubbing and billing to payers and patients as appropriate.
Audits charge entries against medical record documentation to ensure the charges indicated are correct and complete. Provides feedback to physicians/clinical staff regarding charge capture/coding improvements. Requests addendums to documentation where appropriate to support charges billed.
Receives appeal requests from the insurance follow-up team and other areas within the Billing Office and reviews related claims to determine if denials may be appealed. Prepares and submits appeals to payers when appropriate. Requests write off adjustments for managerial approval when an appeal is not available or applicable.
Assists in performing historical coding/ charge reviews to determine trends and areas of opportunities for improvement.
Works EHR billing pending queue to ensure charge capture is complete and accurate before submission to the patient management system.
Requires a degree of flexibility in the assignment of work hours/ shifts. Charges received in a given month must be posted by the close of the month, and at times, overtime and work hours outside of the regular assignment may be required to ensure timely posting.
The responsibilities listed are a general overview of the position, and additional duties may be assigned.

Education, Training, and Experience

High School Diploma or GED?
Minimum candidates with 1+ years of experience coding physician claims or 3+ years of experience or billing experience in an ophthalmology practice.
CCS-P or CPC (non-apprentice) coding certification is preferred.
Effective verbal and written communication skills with patients, physicians, management, employees, and the public.??
Must be able to meet average expectations for productivity and quality standards.
Prefer candidates proficient in utilizing MS Excel for analyzing data using basic formulas, pivot tables, and charts.
Effective verbal and written communication skills with patients, physicians, management, employees, and the public.??

Excellent Organizational skills, multi-task, and logical thinking???
Knowledge of Microsoft Office (Word, Outlook) and the ability to learn and adapt quickly to new software.???
Ability to be proactive, take initiative, and perform well in a fast-paced, high-volume practice.???

Confidentiality
Maintains strict confidentiality regarding protected health information (PHI) and understands and adheres to TNR's HIPAA privacy and security policies and procedures.
Typical Physical and Working Demands
Position requires prolonged walking, sitting, bending, stooping, and stretching. Good eye-hand coordination and manual dexterity are sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. Employees must have a standard hearing range and eyesight to record, prepare, and communicate appropriate reports. Employees must have a standard hearing range and eyesight to record and prepare paper and MDI chart notes and documents. Must be able to lift and carry up to 15 pounds.