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Charge Capture Audit Analyst - Pharmacy - Full Time - Days

Jupiter Medical Center
Jupiter, FL Full Time
POSTED ON 2/4/2025
AVAILABLE BEFORE 5/4/2025

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education

  • Associate degree and / or completion of a relevant formal certification program.
  • Certification / Licenses : Current Pharmacy Technician Registration required.

Experience / Qualifications

  • Minimum of one-year related work experience in pharmacy, outpatient and / or acute care hospital coding preferred.
  • Coding, Revenue Cycle and / or Health Information Management experience preferred.
  • Comprehensive knowledge of hospital revenue cycle operations, hospital charge masters, as well as hospital department charge capture and charge reconciliation.
  • Knowledge of correct coding principles of CPT / HCPCS, ICD-10 and modifier selection, as well as UB04 revenue codes. Must have knowledge and understanding of the official ICD-10-CM outpatient coding guidelines. Knowledge and understanding of the CPT Assistant and Coding Clinics.
  • Comprehensive understanding of Federal, State and Local coding guidelines and payment methodologies.
  • Must possess excellent analytical, organizational, verbal and written communication skills and be professional in both appearance and approach.
  • Ability to reliably work independently in a fast-paced environment and be accountable for accurate results.
  • Must be proficient in MS Office, particularly Excel and Word, and be very detail oriented.
  • Comprehensive understanding of auditing concepts preferred.
  • Epic experience preferred.
  • Position Summary

    The Charge Capture Audit Analyst is responsible to run charge Epic reconciliation and revenue guardian reports, reconcile charges, make charge corrections, and apply charges as applicable.

    Responsibilities include but not limited to :

  • Reconciles pharmacy charges, resolves discrepancies, and submits to leadership for approval for payment.
  • Work and analyze billing error and denial data in assigned Epic work queue to resolve edits and / or errors, make charge corrections, and / or add appropriate modifiers per CPT and CMS guidelines to assure appropriate and compliant revenue.
  • Identifies recurrent charge issues and escalates to manager for resolution.
  • Works with clinical team regarding charge code changes, issues, and / or workflow at the request of manager.
  • Assist Pharmacists with workflow challenges causing charge issues as requested by manager.
  • Provides request for and works with Chargemaster for new charge builds; ensures build is complete in Epic and clinical teams responsible for charging are educated on availability and use.
  • Collaborates with IT for resolution of charge code build issues.
  • Performs other duties as assigned and volunteer for team assignments; actively participate in team projects.
  • Team Member Competencies

    Establishing Relationships

    Builds effective networks, working relationships, and alliances in order to collaborate effectively within department and organization. Can relate to all kinds of people regardless of background; find topics and common interests that can be used to build rapport with others.

    Peer Support

    Provides guidance and feedback to help others strengthen knowledge / skills needed to accomplish tasks, solve problems, and perform effectively within the team.

    Inspiring and Motivating Others

    Fosters commitment and cohesiveness by facilitating cooperation and working as a team within the organization toward goal accomplishments. Work well with others, build consensus, and ensure cooperation to complete tasks and positive workflow.

    Demonstrating Emotional Intelligence

    Exercises self-leadership, self-awareness, and self-regulation; manages emotions so that they are expressed appropriately; leads others by showcasing adaptability, empathy, and social skills.

    Acting with Integrity

    Interacts with others in a way that is seen as direct and truthful; ensures confidence in individual and organizational motives and representations. Acts in a way that is consistent with personal and organizational values by keeping confidence, promises, and commitments. Clearly states goals and beliefs; informs people of their true intentions, does what they say they will do; follows through on commitments.

    Being a Champion for Change and Innovation

    Supports people in their efforts to try new things. Things creatively, generates novel and valuable ideas and uses these ideas to develop new or improved processes. Accepts new ways of doing things and adapts to change.

    Communicating Effectively

    Speaks and writes clearly, conveys information in a concise, organized, and logical manner. Is adept at tailoring the message to fit the interests and needs of the audience. Listens attentively and exercises tact, discretion, and diplomacy when interacting with members of the department and organization.

    Promoting Diversity and Inclusion

    Treats all people with dignity and respect. Demonstrates an open-minded approach to understanding people regardless of their gender, age, race, national origin, religion, ethnicity, disability status, or other characteristics. Challenges bias and intolerance. Develops all-inclusive groups in the realms of social interaction and communication. Shows respect for the beliefs of others; encourages and promotes practices that support cultural diversity; discourages behaviors or practices that may be perceived as unfair, biased, or critical toward people with certain backgrounds.

    Physical Requirements

  • Office -2 Grip dynamometer 10 seconds / 10lbs; pinch thumb and forefinger 10 seconds / 2lbs; rotate wrist with 10 lb weight; flex and extend elbow with 10lb weight; raise shoulder 135 degrees forward and shrug shoulders with 10lb weight; squat; kneel on single knee; push and pull stationary cart with force of 40lbs; carry 10lb weight 30 feet; lift 20lb weight floor to table / table to floor; and lift 10lb weight table to shoulder height.
  • Threshold Requirements

  • These threshold requirements are required and completed yearly basis
  • Annual Joint Commission mandatory education requirements, in-service and health requirements including attendance at new employee orientation

  • TB / PPD Surveillance Program
  • Maintenance of required professional licensing and / or certification(s).
  • This is not necessarily an extensive list of all responsibilities, skills, duties, requirements, or working conditions associates with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or require that other or different tasks be performed when circumstances change (i.e. emergencies, changes in personnel, workload, rush jobs or technical developments). I have reviewed these job requirements and verify that I can perform all essential functions of this position.

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