Charge Review Specialist - Medical Billing
Charge Review Specialist – Medical BillingJob Summary We are seeking a detail-oriented and experienced Charge Review Specialist to join our medical billing team. This position is responsible for reviewing and auditing medical claims prior to submission to insurance carriers to ensure accuracy, completeness, and compliance with coding and billing guidelines. The ideal candidate will have a strong understanding of medical billing, CPT and ICD-10 coding, and the ability to identify missing charges, coding errors, and billing discrepancies to prevent claim denials and maximize reimbursement.
Key Responsibilities
Review and audit medical claims for accuracy and completeness prior to submission to insurance carriers. Identify missing charges, coding omissions, incorrect CPT/ICD-10 codes, modifiers, and billing discrepancies. Compare charges against medical records, operative reports, and supporting documentation to ensure all billable services are captured. Verify appropriate coding, modifiers, units, and other required billing information. Identify potential claim denials or reimbursement issues and resolve discrepancies before submission. Communicate with billing staff, coding teams, and providers to clarify documentation or resolve claim issues. Ensure claims comply with payer-specific billing requirements and applicable coding guidelines. Maintain accurate records of audit findings, corrections, and outstanding issues. Assist with improving charge capture accuracy and reducing billing errors and claim rejections.
Qualifications
Previous experience in medical billing, charge capture, coding, or claims auditing preferred. Strong knowledge of CPT, ICD-10, HCPCS codes, and medical billing procedures. Experience reviewing medical records and operative reports for billing accuracy. Ability to identify coding errors, missing charges, and documentation discrepancies. Familiarity with insurance billing requirements, claim submission processes, and denial prevention. Excellent attention to detail, organizational skills, and problem-solving abilities. Ability to work independently, prioritize workloads, and meet deadlines. Experience with AdvancedMD or similar practice management software is a plus. Experience with anesthesia or surgical billing is preferred. Ideal Candidate The successful candidate will be highly analytical, detail-oriented, and proactive in identifying billing issues before claims are submitted. They should be comfortable reviewing large volumes of claims while maintaining accuracy and communicating effectively with the billing team. Our Goal: Ensure every claim is accurate, complete, properly coded, and ready for submission to minimize denials, prevent lost revenue, and improve overall revenue cycle performance. Pay: $30.00 - $35.00 per hour Expected hours: 40.0 per week Work Location: Remote