Charge Entry Senior Analyst

Work Location: Bridgetowne, Quezon City
Work Arrangement: Onsite
Shift: Night Shift
Employment Type: Full-time

Job Description

We are looking for a Charge Entry Senior Analyst to join our Healthcare Revenue Cycle Management team. The role is responsible for accurate and timely charge entry, claim edit resolution, authorization validation, and ensuring charges are complete and ready for claim submission.

The successful candidate will work closely with physicians, clinical teams, Coding, Authorization, and other Revenue Cycle teams to resolve issues that may impact clean claim submission and reimbursement.

Key Responsibilities

• Perform accurate and timely entry of surgical and other healthcare charges into the practice management or patient accounting system.
• Review physician-provided procedure and diagnosis information to ensure charges and claims are complete and accurate.
• Review supporting documentation and identify missing, conflicting, or unclear information requiring further clarification.
• Maintain the integrity of physician-provided coding and appropriately route coding-related questions to the appropriate Coding or clinical team.
• Review authorizations and validate that physician-provided procedure information aligns with authorized services.
• Research and resolve front-end billing and claim edits related to patient demographics, insurance information, provider information, coding, modifiers, authorizations, and payer requirements.
• Analyze claim edits to identify root causes and determine appropriate resolution or escalation.
• Apply knowledge of payer requirements and billing guidelines when resolving charge and claim issues.
• Coordinate with physicians, clinical staff, Coding, Authorization, Credentialing, and other Revenue Cycle teams to resolve charge and billing issues.
• Monitor assigned work queues and outstanding charge activity to ensure timely processing.
• Maintain accurate documentation of research, actions taken, outstanding issues, and resolutions.
• Identify recurring charge entry errors, claim edits, and workflow issues and communicate findings to appropriate leadership.
• Support continuous improvement initiatives focused on charge accuracy, clean claim submission, operational efficiency, and timely reimbursement.
• Maintain patient confidentiality and appropriately handle protected health and financial information.

Qualifications

• At least 3 years of experience in Healthcare Revenue Cycle Management, Medical Billing, Charge Entry, Claims Processing, or a related healthcare revenue cycle function.
• Direct experience with charge entry and/or resolving front-end billing and claim edits.
• Experience working with physician-provided procedure and diagnosis information.
• Experience using an EMR, practice management, or patient accounting system.
• Working knowledge of CPT, ICD-10, HCPCS, and modifiers.
• Knowledge of healthcare claims processes, payer requirements, authorizations, and clean claim submission.
• Strong analytical, critical-thinking, and problem-solving skills.
• Excellent attention to detail and ability to work accurately in a high-volume environment.
• Strong organizational and time-management skills.
• Good verbal and written communication skills.
• Willing to work onsite in Bridgetowne, Quezon City and on a night shift.

Preferred Qualifications

• Orthopedic surgical charge entry or billing experience is strongly preferred.
• Experience in a multi-specialty physician practice, orthopedic practice, or high-volume ambulatory healthcare environment.
• Experience with athenaOne or comparable practice management/patient accounting systems.
• Familiarity with commercial insurance, Medicare, Medicaid, Workers' Compensation, and other healthcare payers.
• Medical billing, Revenue Cycle, or coding-related certification is an advantage.

Skills and Competencies

• Charge entry and claim creation
• Front-end claim edit resolution
• CPT, ICD-10, HCPCS, and modifier knowledge
• Authorization validation
• Payer and billing requirements
• Claims processing and clean claim submission
• EMR/practice management systems
• Research and issue resolution
• Strong attention to detail and accuracy
• Ability to manage multiple work queues and priorities
• Effective communication and stakeholder coordination