Ambulatory Charge Capture Analyst
WVU Medicine · Morgantown, WV · 4 mo ago
On-siteBusiness DevelopmentFull-time
About the role
The Ambulatory Charge Capture Analyst serves as an embedded revenue cycle specialist within assigned clinical department(s), ensuring accurate and complete charge capture for all billable services, procedures, and supplies. This role bridges clinical operations and revenue cycle functions by providing dedicated expertise in charge reconciliation, staff education, and process improvement. The analyst reports directly to Ambulatory Administration, with a strong collaborative relationship to the department leadership (matrixed reporting).
Responsibilities
- Conduct daily/weekly reconciliation of clinical activity against billed charges for assigned department(s).
- Review case/procedure schedules, supply usage, and documentation to identify missing, incorrect, unbilled charges.
- Validate that all chargeable services, procedures, implants, devices, and supplies are accurately captured in the billing system.
- Investigate discrepancies between documented services and charges submitted. Take corrective action for missing charges in accordance with Revenue Integrity system team guidelines.
- Monitor charge lag time and ensure timely charge entry to support claim submission deadlines.
- Identify patterns of revenue leakage and recurring charge capture errors.
- Serve as the primary resource for department staff on charge capture policies, procedures, and best practices.
- Provide ongoing education to clinical and administrative staff regarding chargeable items and proper documentation requirements.
- Develop and deliver training materials, quick reference guides, and workflow tools specific to department needs.
- Communicate updates to Revenue Integrity System team any changes that impact charge capture.
- Act as liaison between department staff and Revenue Integrity System team to answer questions and resolve issues.
- Generate and analyze reports to track charge capture performance, revenue recovered, and compliance metrics.
- Prepare regular updates for Revenue Integrity leadership and department management on findings, trends, and opportunities.
- Maintain documentation of charge corrections, revenue impact, and root cause analysis.
- Maintain documentation of charge corrections, revenue impact, and root cause analysis.
- Monitor key performance indicators including reconciliation completion rates, charge accuracy, and financial impact.
- Support internal and external audits by providing documentation and analysis as needed.
- Collaborate with Revenue Integrity leadership, IT, and department stakeholders to implement sustainable solutions.
- Participate in new service line implementations and system upgrades to ensure proper charge capture from launch.
- Participate in Revenue Integrity team meetings and cross-departmental initiatives.
- Build strong working relationships with coding, billing, compliance, and clinical documentation teams.
Requirements
- High school diploma AND six (6) years of experience in business analysis or clinical/nursing experience OR bachelor’s degree in finance, business management, information technology/computer science, healthcare administration, nursing or related field AND two (2) years of experience in business analysis or clinical/nursing experience, or similar role.
- Preferred qualifications include Lean Six Sigma certification, experience with Lean Six Sigma, experience with revenue cycle, experience with Excel, PowerPoint, Tableau, etc., experience with the development and maintenance of metrics and communication dashboards, experience with EPIC electronic health record.
Qualifications
- Education, Certification, and/or Licensure: High school diploma AND six (6) years of experience in business analysis or clinical/nursing experience OR bachelor’s degree in finance, business management, information technology/computer science, healthcare administration, nursing or related field AND two (2) years of experience in business analysis or clinical/nursing experience, or similar role.
- Preferred Qualifications: Lean Six Sigma certification. Experience with Lean Six Sigma. Experience with revenue cycle. Experience with excel, power point, tableau, etc. Experience with the development and maintenance of metrics and communication dashboards. Experience with EPIC electronic health record.
Skills and Abilities
- Excellent written and verbal communication skills, as well as interpersonal skills necessary to communicate effectively.
- Knowledge of related provider healthcare compliance, revenue cycle operations and auditing techniques required.
- Ability to mentor, educate and train others.
- Ensure quality and productivity standards.
- Handle high stress and critical situations in a calm and professional manner.
- Concentrate and maintain accuracy during constant interruptions.
- Independent decision-making ability.
- Organizational and time management skills.
- Knowledge of anatomy, physiology, and medical terminology.
- Analytical and problem-solving skills.
- Proficient in office software programs including medical record and billing systems.
- Ability to analyze complex data and reports.
- Specific understanding of APC/MPFS payment structures and other third-party payment methodologies.