Charge Capture and Billing Specialist

Position Title: Charge Capture & Billing SpecialistDepartment: Revenue CycleReports To: Director of Charge Capture and BillingLocation: On sitePosition SummaryThe Charge Capture & Billing Specialist is responsible for overseeing all activities related to professional and/or facility charge capture, medical coding accuracy, billing workflows, and reimbursement optimization. This role ensures compliance with applicable regulations, maintains revenue integrity, and drives operational efficiency across the revenue cycle. The Specialist provides leadership to charge capture and billing teams, partners with clinical departments, and ensures timely, accurate claim submission.Key ResponsibilitiesCharge Capture OversightLead and manage the daily operations of charge capture workflows to ensure all services are accurately recorded and billed.Develop processes to reduce leakage, prevent missing or incomplete charges, and improve overall charge accuracy.Collaborate with clinical departments to ensure documentation supports compliant charge capture.Monitor edits, charge review queues, and billing worklists; resolve issues promptly.Billing & Coding ManagementOversee billing processes to ensure timely claims submission and adherence to payer guidelines.Review coding accuracy, ensuring alignment with CPT, ICD 10, HCPCS, and payer policy requirements.Serve as a subject matter expert on billing compliance, coding rules, and reimbursement methodologies (e.g., RVUs, APCs, RBRVS).Partner with auditors and compliance teams to mitigate risk and implement corrective action plans.Revenue Integrity & ComplianceEnsure all billing practices comply with state, federal, and payer regulations, including Medicare/Medicaid.Monitor trends in denials, rejections, and underpayments; implement process improvements to reduce errors.Develop policies and procedures for charge capture, coding, and billing operations.Drive adoption of internal controls to ensure data integrity and compliance with organizational guidelines.Leadership & Team DevelopmentManage, mentor, and evaluate billing/charge capture staff.Provide ongoing training related to coding updates, compliance changes, and system enhancements.Collaborate cross functionally with clinical leaders, IT, compliance, and finance.Reporting & AnalyticsDevelop and distribute reports on charge capture performance, coding accuracy, billing productivity, and key revenue metrics.Analyze trends and proactively identify revenue opportunities or operational issues.Support leadership with strategic project planning and revenue cycle initiatives.