Regional Billing Specialist - Ambulatory Charge Capture Services

SUMMARY

This position is responsible for the accurate and timely charge capture and reconciliation of both professional and technical charges across complex, multi-specialty oncology service lines. The role requires strong analytical skills to review charges and clinical documentation, ensuring alignment with CPT / HCPCS coding standards and industry guidelines to support revenue integrity. Effective communication and customer service skills are essential, as the position works closely with management, providers, and clinical support teams to resolve discrepancies and promote accurate documentation and charge practices.

JOB SPECIFIC COMPETENCIES

Charge Capture of Professional and Technical / Facility Charges

Ensure timely and accurate daily charge capture submission for multi-specialty professional and technical (hospital) services across assigned centers, in compliance with institutional billing and charge submission policies.

Review and analyze complex professional and facility revenue mapping, billing, and documentation for accuracy; escalate discrepancies to management and provide education to providers and clinical staff as needed.

Monitor all charge entry processes for completeness and accuracy. Investigate compliance issues, identify improvement opportunities, and collaborate with management to deliver training and implement corrective measures.

Stay current with industry standards and institutional billing compliance guidelines, including CPT-4, ICD-10-CM, and HCPCS code updates.

Manage open encounter workflows :

Professional Encounters : Review, track, and communicate outstanding encounters to providers; summarize status for center management.

Technical Encounters : Monitor daily and coordinate with nursing staff to close open encounters and capture all charges.

Initiate and implement charge corrections, including researching root causes and updating the billing system to ensure claims are compliant and accurately submitted.

Notify management of any systemic or recurring issues affecting charge capture timeliness or compliance.

Support Charge Description Master (CDM) maintenance and analysis, ensuring correct supply charge entries and identifying new billable items.

Adhere to standardized workflows and productivity metrics as established by department and institutional policies.

Maintain professional and effective communication with providers, clinical support teams, and leadership.

Provide training and support to providers, billing staff, and clinical teams; cross-train and assist across centers as needed.

Charge Reconciliation of Professional and Technical / Facility Charges

Reconcile charges daily to identify discrepancies or omissions and ensure timely, accurate billing for services rendered.

Utilize designated reconciliation tools and work queues, including reconciliation reports and EMR documentation, to verify compliant charge submission.

Communicate proactively with providers and clinical staff to resolve missing or incomplete charges.

Identify and escalate inaccuracies in charge submission and revenue mapping, collaborating with management to implement corrective actions.

Maintain consistent performance standards aligned with departmental productivity and workflow guidelines.

Provide cross-functional training and support for clinical and billing staff; work across centers as required.

• Professional Charge Capture and Reconciliation for Outside Facility Rounding Services

Oversee charge capture, entry, and reconciliation processes for professional services provided by Houston Area Location Faculty at outside facilities.

Obtain and manage access to external EMRs for accurate charge documentation and medical record retrieval.

Verify and validate patient registration, including insurance and demographic data, to ensure complete and accurate billing.

Obtain financial information needed to determine financial eligibility according to MD Anderson managed care contracts.

Retrieve, review, and abstract external medical records to support submitted charges, ensuring accurate assignment of CPT and ICD-10-CM codes.

Project Management and Reporting

Support ongoing billing compliance monitoring and deliver educational sessions for staff and clinical team.

Contribute to CDM analysis and maintenance to ensure correct supply charge capture and identification of new chargeable items.

Collect, analyze, and summarize data for special projects and reporting purposes.

Develop and oversee charge reconciliation and audit workflows for professional and technical services to ensure completeness and accuracy of billing.

Identify opportunities for process improvement; escalate issues and implement corrective actions in collaboration with management.

Perform additional duties and responsibilities as assigned.

Other duties as assigned

Education

Required : Associate's degree in Business Administration or related field.

Preferred : None

Certification

• Required :
• None

Preferred : Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) through the AAPC (American Academy of Professional Coders), or Certified Coding Specialist-Physician based (CCS-P) or Certified Coding Specialist (CCS) through AHIMA (American Health Information Management Association).

Experience

Required : Four years professional fee billing experience in healthcare or insurance field. May substitute required education degree with additional years of experience on a one to one basis.

• Preferred :
• Experience in a physician's office / group practice for professional charge capture, working knowledge of CPT / HCPCS code assignment and understanding of supporting documentation. Epic and coding experience; coding certification is a plus.

The University of Texas MD Anderson Cancer Center offers excellent , tuition benefits, educational opportunities, and individual and team recognition.

This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity / expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.

Additional Information

Requisition ID : 176627

Employment Status : Full-Time

Employee Status : Regular

Work Week : Days

Minimum Salary : US Dollar (USD) 60,500

Midpoint Salary : US Dollar (USD) 75,500

Maximum Salary : US Dollar (USD) 90,500

FLSA : exempt and not eligible for overtime pay

Fund Type : Hard

Work Location : Remote (within Texas only)

Pivotal Position : No

Referral Bonus Available? : No

Relocation Assistance Available? : No

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