Outpatient Charging Specialist Senior plays a key role in maintaining financial integrity by verifying and entering charges for outpatient services. This position ensures alignment between clinical documentation and billing practices, following federal guidelines and organizational policies to support accurate reimbursement.
Key Responsibilities
- Review clinical records across multiple systems to validate service documentation and assign correct codes
- Enter charges into the clinical system using approved methods, including charge tickets
- Apply CMS, OPPS, HCPCS, and CPT guidelines to maintain compliance
- Collaborate with clinical staff and revenue cycle teams to resolve discrepancies and improve charge capture accuracy
- Support charge description master (CDM) updates in coordination with Revenue Integrity
- Provide guidance on charging practices, documentation requirements, and reimbursement rules
- Conduct analysis of billing patterns to identify risks and opportunities related to payer compliance
- Partner with nursing leadership to enhance revenue optimization and documentation practices
- Participate in training initiatives to improve team understanding of coding and billing standards
- Assist with special projects and operational improvements as needed
Required Qualifications
- Four years of experience in healthcare, including clinical, coding, billing, or patient accounting roles
- At least one year in a provider setting such as infusion, radiology, surgery, pharmacy, or lab
- Bachelor’s degree and active Florida RN license
- Familiarity with CDM, OPPS, HCPCS, and CPT coding systems
- Knowledge of Medicare/Medicaid, managed care contracts, and claims processing
- Proficiency in Word, Excel, Access, and PowerPoint for reporting and analysis
- Strong problem-solving, communication, and project management abilities
- Ability to work independently and maintain confidentiality of sensitive data
Preferred Skills
- Experience with Cerner and Soarian electronic health record systems
- Background in coding or CDM maintenance
Work Environment
This is an onsite position requiring daily presence at the facility. The organization is committed to advancing cancer care through innovation and excellence in clinical and financial operations.
Organizational Commitment
The institution is dedicated to improving patient outcomes and shaping the future of oncology care. It has earned national recognition for workplace culture and digital health leadership, fostering an environment of continuous learning and operational excellence.
