- Review patient records and medical documentation for accurate charge entry.
- Verify patient details, provider information, and dates of service.
- Ensure all required documentation is available before entering charges.
2. Charge Entry Processing
- Accurately enter medical charges into billing software or practice management systems.
- Ensure correct entry of CPT, ICD-10, and HCPCS codes based on supporting documentation.
- Verify modifiers, units, and applicable service details.
- Ensure accurate charge capture and prevent missed or duplicate charges.
3. Claim Accuracy and Validation
- Validate patient demographics and insurance information.
- Identify and correct charge entry errors and discrepancies.
- Ensure charges are entered according to payer-specific billing guidelines.
- Prepare accurate claims for timely submission to insurance companies.
4. Coordination and Productivity
- Coordinate with coding and billing teams to resolve documentation and coding-related issues.
- Follow established charge entry workflows and quality standards.
- Meet daily productivity, accuracy, and turnaround time (TAT)
targets.
- Maintain compliance with company policies and US healthcare billing guidelines.
Required Skills and Qualifications
- Knowledge of US Healthcare Medical Billing and Revenue Cycle Management (RCM).
- Good understanding of CPT, ICD-10-CM, and HCPCS coding systems.
- Knowledge of medical terminology and healthcare procedures.
- Understanding of insurance claims and charge entry processes.
- Hands-on experience with medical billing software or practice management systems.
- Robust analytical and problem-solving skills.
- Excellent attention to detail and accuracy.
- Good communication and teamwork skills.
Preferred Qualifications
- Previous experience in US Healthcare Medical Billing, particularly in Charge Entry.
- Familiarity with EHR and practice management software such as Epic, Athenahealth, eClinicalWorks, NextGen, ModMed, Allscripts, or similar platforms.
- Basic knowledge of Medicare, Medicaid, and commercial insurance billing guidelines.