As a key member of the revenue cycle management department, The Billing Charge Review and Combine Specialist is responsible for reviewing, reconciling, and combining patient charges to ensure accurate, complete, and timely billing of healthcare services. This role ensures compliance with payer guidelines, internal policies, and regulatory requirements, supporting optimal revenue capture and reducing claim rejections or delays.

Charge Review and Validation

• Review daily charge batches for accuracy and completeness before submission.
• Validate CPT, HCPCS, ICD-10, and revenue codes in alignment with payer requirements and clinical documentation.
• Identify and correct duplicate, inconsistent, or inappropriate charges.

Charge Combining

• Consolidate charges from multiple encounters, services, or departments when appropriate, following facility protocols and payer billing rules.
• Ensure combined charges accurately reflect services rendered while maintaining integrity of supporting documentation.

Billing Preparation

• Release approved charges to the billing system in a timely manner to support prompt claims submission.
• Collaborate with coding, billing, and clinical teams to resolve discrepancies.

Compliance and Quality Assurance

• Adhere to organizational policies, payer guidelines, and regulatory requirements, including HIPAA.
• Monitor edits and rejections related to charge entry; implement corrective actions.
• Maintain detailed documentation of charge review and combining activities.

Communication and Collaboration

• Respond to internal inquiries regarding charge issues.
• Participate in audits and provide supporting documentation as needed.
• Educate clinical and operational staff on common charge errors or trends.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

• High school diploma or equivalent required; Associate’s degree in a healthcare related field preferred.
• Minimum 2 years of experience in charge entry, billing, coding, or revenue cycle operations.
• Strong understanding of healthcare regulations, payer policies, and reimbursement processes.
• Excellent organizational and communication skills, with attention to detail.
• Proficiency in using relevant software and databases for enrollment and data analysis.
• Ability to work independently and collaboratively in a dynamic healthcare environment.
• Must be able to read, write legibly, speak, and comprehend English.

WORKING CONDITIONS

WORK CONTEXT

• Coordinate and lead others
• Deal with external customers/vendors
• Provide business appropriate letters, memos, and emails
• Public speaking
• Work well within a group or team

• Freedom of decision making without supervision
• Understanding impact of decisions on the Health System
• Fast-paced and under time pressure

PHYSICAL FACTORS

• The Americans with Disabilities Act (ADA) requires the job description to document physical factors, including ability, activities, and requirements.
• Ability: Gross Body Equilibrium and Coordination.
• Activities: Talking, hearing, walking, repetitive motion, standing, and/or using hands to handle, control, or feel objects, tools or controls.
• Requirements: Please indicate the physical requirements of the job as one of the following:
  • Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

• Must be able to perform the duties with or without reasonable accommodation.
• Hearing and vision must be normal or corrected to within normal range.
• Physical presence onsite is essential.

OTHER JOB FACTORS

• Deductive reasoning, fluency of ideas, problem sensitivity, oral comprehension, oral expression, written expression, speed of closure.
• Achieve goals set forth in job, ability to adapt to surroundings and continuous change, attention to detail, initiative, independence, stress tolerance, leadership, integrity and cooperation.
• Ability to build relationships, create a support structure for those in the Health System, provide recognition to those achieving the accolades, and satisfy work task independently.