The Professional Billing (PB) Senior Charge Management Coordinator is a key member of the Revenue Integrity team ensuring accurate, compliant, and efficient professional billing by partnering closely with PB Coding, PB Billing, clinical departments, and IT. This role safeguards revenue through expert knowledge of Epic, strong analytical skills, and deep understanding of clinical workflows, documentation, and regulatory requirements.
1. Charge Capture & Revenue Integrity
- Ensure all professional charges are accurately captured, routed, and posted.
- Review Epic testing to confirm charges generate as expected; research and resolve discrepancies.
- Monitor charge reconciliation, charge lag, and revenue leakage trends.
- Support new service lines and workflow changes to maintain accurate charge capture.
2. Epic Systems Expertise
- Maintain in‑depth knowledge of Epic functionality, charge router logic, and clinical workflows.
- Translate clinical and operational needs into Epic solutions that improve workflow and reduce compliance risk.
- Participate in system testing, upgrades, and build validation for clinical and billing applications.
- Provide ongoing Epic support to end users and identify opportunities for system optimization.
3. Coding Collaboration
- Partner with PB coders to resolve documentation gaps, coding questions, and charge discrepancies.
- Review coding edits and denials; identify root causes and implement corrective actions.
- Support coding accuracy through education, audit participation, and trend analysis.
4. Billing & Claims Support
- Work with PB Billing, Administrators, Physicians and Coding Educators to resolve claim edits, rejections, and denials.
- Validate claim accuracy for high‑risk or high‑dollar encounters.
- Ensure compliance with payer rules, federal/state regulations, and internal policies.
5. Workflow Optimization & Compliance
- Document current workflows and identify opportunities to maximize Epic functionality.
- Apply established Epic policies and assess the impact of system changes.
- Maintain knowledge of regulatory requirements (e.g., Medicare) and request system modifications as needed.
- Provide cost‑effective, process‑efficient recommendations for system enhancements.
6. Education, Training & Communication
- Coordinate with Coding Education on documentation, coding changes, and Epic functionality.
- Provide support during go‑lives and workflow transitions.
- Support the development of job aids, tip sheets, and communication materials.
- Serve as a liaison between coding, billing, clinical teams, and IT.
7. Audit & Quality Assurance
- Conduct internal audits of documentation, coding, and charge capture.
- Validate accuracy in high‑risk specialties and ensure corrective actions are implemented.
- Monitor compliance risks and support mitigation strategies.
8. Cross‑Functional Collaboration
- Work with clinical leaders, IT, administrators, and revenue cycle teams to improve processes.
- Participate in committees, workgroups, and revenue integrity initiatives.
- Support leadership with data, analysis, and recommendations for financial improvement.
MINIMUM REQUIREMENTS
Education: Bachelor’s degree required or relevant experience may be considered in lieu of Bachelor's degree.
Experience: A minimum of five years of experience required in a complex hospital setting Knowledge of third party billing and reimbursement methodologies required Understanding of CPT level II and III HCPCS and hospital charging methods is essential General comprehension of medical terminology is necessary.
Licensure: none
PHYSICAL DEMANDS
Job requires sitting for prolonged periods, frequently traveling (no more than two miles); Repetitive motion: (Typing). Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly; Ability to lift/push/pull < 20lbs. May be exposed to cold, heat and outdoor climate.
The starting base rate for this role is $90,000.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.
Job Profile
J1714 - Revenue Cycle Professional 3
Career Stream and Level
Professional-P3
The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment.
