Charge Review/Entry Specialist

The Charge Review/Charge Entry Specialist is responsible for accurately reviewing and entering patient charges into the billing system to support timely, compliant claim submission and optimal reimbursement.

Requirements

• Review all supporting documentation to confirm all billable services are captured.
• Enter charges into the practice management (PM) and/or electronic health record (EHR) system accurately and within required turnaround times.
• Validate required billing elements (date of service, rendering/provider, location, diagnosis pointers, units, modifiers, NDC/lot where applicable) prior to claim submission.
• Identify, research, and correct charge discrepancies such as missing charges, duplicate charges, incorrect units, invalid modifiers, or mismatched diagnosis-to-procedure linkage.
• Apply client-specific charge rules, fee schedules, and payer billing guidelines; escalate unusual scenarios or compliance concerns appropriately.
• Work charge edits, hold queues, and worklists; document actions taken and maintain clear audit trails in the system.
• Communicate with providers, staff, and internal teams to obtain missing information and resolve documentation issues.
• Support claim quality by reducing downstream rework, denials, and payment delays through proactive charge accuracy checks.
• Maintain productivity and quality standards.
• Participate in training and follow HIPAA and company policies for PHI.
• Assist with periodic audits, reconciliation, and reporting.
• Perform all other functionally related duties and special projects as assigned and needed.