Charge Entry Specialist chez METRO COMMUNITY HEALTH CENTER

Description

POSITION SUMMARY:

The Charge Entry Specialist plays a key role in supporting the mission of the health center by ensuring accurate and compliant billing for medical and mental health services. This position is responsible for reviewing provider documentation, assigning appropriate CPT/HCPCS and ICD-10 codes, and entering charges into the electronic billing system for both primary care and behavioral health encounters. The specialist ensures that billing aligns with FQHC, Federal and State Guidelines as well as payer requirements, supporting the organization’s ability to provide accessible and sustainable care to the community.

ESSENTIAL FUNCTIONS:

Charge Entry & Coding

• Review provider documentation for medical and mental health encounters to assign accurate CPT, HCPCS, and ICD-10 codes.
• Enter daily charges into the EHR/Practice Management system in a timely and accurate manner.
• Ensure coding reflects FQHC-specific billing requirements, including PPS/RHC encounter rules, T1015 requirements, and modifier usage.

Compliance & Accuracy

• Verify coding and charge entry for accuracy and completeness to support clean claim submission and compliance with FQHC, federal, and state billing regulations.
• Identify and resolve discrepancies or incomplete documentation by working collaboratively with providers, clinical staff, and compliance teams.
• Stay current on changes to CPT, ICD-10, HCPCS, and payer billing guidelines, including updates specific to FQHC billing.

Collaboration & Revenue Cycle Support

• Partner with billing and A/R staff to minimize denials and support prompt reimbursement.
• Assist with follow-up and resolution of claim denials or rejections related to coding or charge entry.
• Contribute to departmental productivity goals and the organization’s revenue cycle performance.
• Assist with AR reviews and clean up with may include reaching out to payers and researching on the portals.

Mission & Patient Focus

• Uphold the mission of the FQHC by ensuring billing processes are compliant, ethical, and support the financial sustainability of providing care to underserved communities.
• Maintain strict patient confidentiality and adhere to HIPAA and organizational privacy policies.

Qualifications

POSITION REQUIREMENTS:

Education/Experience

• High School Diploma or equivalent required; Associate degree or coding certification (CPC, CCA, CCS, or equivalent) preferred.
• 1–2 years of medical billing and coding experience, preferably in an FQHC or similar healthcare environment preferred.
• Working knowledge of CPT, HCPCS, ICD-10 coding systems, and payer billing requirements.
• Familiarity with FQHC-specific billing practices, such as PPS reimbursement, and sliding fee scales, strongly preferred.
• Experience with AthenaOne EMR system preferred.

Skills/Abilities

• Strong organizational skills, attention to detail, and ability to meet productivity and accuracy standards.
• Excellent communication and problem-solving skills; ability to work collaboratively with clinical and administrative teams.

Physical Requirements

While performing the duties of this job, the employee is regularly required to sit; use hands to manipulate objects, tools or controls; reach with hands and arms; and talk and hear.  The employee must frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 75 pounds.  Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.  Noise level in the work environment is usually quiet.