Charge Entry Representative

Position Summary

The Charge Entry Representative is responsible for the accurate and timely entry, review, and processing of patient charges within electronic medical record (EMR) and practice management systems. This position reviews charges for coding and billing accuracy, including CPT and ICD-10 codes, modifiers, insurance information, referring physician information, and required authorizations.

The Charge Entry Representative works with multiple systems and platforms, including ModMed, Clinix, Nextech and AdvancedMD. The ideal candidate is highly detail-oriented, organized, and able to meet productivity and turnaround-time expectations while maintaining a high level of accuracy and compliance with HIPAA requirements.

Essential Duties and Responsibilities

• Enter and process charges received through EMR systems, superbills, scan cards, and other approved sources.
• Review and scrub charges to ensure accuracy and completeness prior to claim submission, including:
• • CPT codes
  • ICD-10 diagnosis codes
  • Modifiers
  • Insurance information
  • Referring physician information
  • Required authorizations
• Process charges for assigned providers within 48 hours of receipt.
• Process a minimum of 400 charges per day, while maintaining established quality and accuracy standards.
• Identify missing, incomplete, or inaccurate information that may prevent timely claim submission.
• Communicate with physician offices regarding missing or incomplete claim information using appropriate communication methods, including fax and deficiency processes.
• Upload and process scan cards and other supporting documentation as required.
• Work across multiple systems and platforms, including ModMed, Clinix, Nextech, and AdvancedMD.
• Identify recurring or systematic errors and promptly notify the Supervisor of error patterns or issues requiring additional attention.
• Follow established deficiency procedures and ensure outstanding information is appropriately documented and communicated.
• Maintain confidentiality and comply with all applicable HIPAA requirements, policies, and procedures.
• Perform other related duties as assigned.

Required Qualifications and Experience

• High school diploma or equivalent.
• Minimum of one year of relevant charge entry, medical billing, medical coding, or healthcare revenue cycle experience.
• Working knowledge of CPT and ICD-10 coding.
• Experience working with electronic medical record (EMR) or practice management systems.
• Basic to intermediate computer proficiency.
• Ability to work across multiple systems and platform, including ModMed, Clinix, Nextech, and AdvancedMD

Core Competencies

Attention to Detail

Demonstrates a high level of accuracy when reviewing and entering charges, coding information, insurance details, and supporting documentation.

Productivity and Time Management

Effectively prioritizes and manages multiple assignments while consistently meeting established productivity and turnaround-time expectations.

Independent Judgment

Works independently within established procedures and identifies issues requiring escalation to a Supervisor or other appropriate resource.

Communication

Communicates clearly and professionally with physician offices, coworkers, supervisors, and other internal or external contacts to resolve missing or inaccurate information.

Teamwork

Works collaboratively within a team-oriented environment and contributes to departmental goals and service standards.

Adaptability

Transitions effectively between multiple accounts, providers, systems, and tasks while maintaining accuracy and productivity.

Compliance and Confidentiality

Maintains patient confidentiality and follows HIPAA requirements, organizational policies, and established procedures.

Performance Expectations

Success in this position is measured by the employee's ability to:

• Consistently meet established charge-volume and turnaround-time expectations.
• Maintain accurate and complete charge entry.
• Identify and appropriately resolve or escalate charge deficiencies.
• Demonstrate working knowledge of CPT and ICD-10 coding requirements.
• Follow established workflows and deficiency procedures.
• Maintain compliance with HIPAA and organizational policies.
• Effectively manage multiple providers, accounts, and technology platforms.

West Coast Dermatology Billers is a medical billing company with a focus on dermatology. We believe it takes communication, respect, trust, and empathy to create a positive culture in the workplace. We pride ourselves on quality, ethics, and having the best of the best with an average staff tenure of 8 years.