Perioperative Charge Analyst

Position Summary:

Under the direction of the Perioperative Business Manager, the Perioperative Charge Analyst is responsible for accurately reviewing, auditing, and reconciling surgical charges to ensure appropriate billing, coding, and revenue capture. This role involves collaborating with clinical, materials management, and financial teams to identify and correct charging discrepancies, ensure compliance with coding regulations, and optimize revenue cycle performance.

Qualifications:

Education:

• Bachelor's degree in Health Information Management, Business, Finance, or a related field preferred.
• Nurse, CST, or healthcare-related clinical background is a plus.

Experience

• 2+ years of experience in Operating Room (OR) charge auditing, billing, or revenue cycle management.
• Experience with surgical case documentation, coding, and charge reconciliation.
• Familiarity with CPT, HCPCS, and ICD-10 coding.
• Experience with EPIC, Cerner, Meditech, or other EHR systems is highly desirable.
• Strong knowledge of OR procedures, supplies, and equipment billing.
• Proficiency in charge auditing and reconciliation processes.
• Analytical skills with the ability to identify and resolve charge discrepancies.
• Attention to detail and accuracy in reviewing and reconciling charges.
• Ability to collaborate with both clinical and financial teams effectively.
• Excellent organizational, communication, and problem-solving skills.

Duties & Responsibilities:

Charge Capture and Reconciliation:

• Review and validate OR charges to ensure accuracy and compliance with hospital policies, CPT codes, and payer guidelines.
• Reconcile surgical case records with billed charges, identifying missing or incorrect charges.
• Verify proper documentation and charge entry for implants, supplies, medications, and procedures.
• Collaborate with clinical staff to ensure accurate charge documentation during and after procedures.
• Investigate and resolve charge discrepancies in a timely manner.

Revenue Integrity and Compliance:

• Ensure all charges comply with CMS, HIPAA, and payer regulations.
• Perform routine audits of OR case documentation to identify and prevent undercharging, overcharging, or billing errors.
• Assist in implementing charge capture policies that adhere to regulatory and compliance standards.
• Identify trends in charge errors or denials and recommend corrective actions.

Data Analysis and Reporting:

• Analyze charge data to identify billing trends, errors, and revenue opportunities.
• Prepare and present financial and charge accuracy reports to leadership.
• Identify patterns of missing charges and recommend process improvements.
• Monitor key performance indicators (KPIs) related to charge accuracy and revenue capture.

Collaboration and Communication:

• Act as a liaison between clinical and financial teams to resolve charge-related issues.
• Work closely with coding, billing, and revenue cycle departments to ensure proper charge alignment.
• Provide charge education and training to OR staff on accurate charge capture and documentation practices.
• Participate in interdisciplinary meetings to review and improve charge capture processes.