Cardiovascular Services of America (CVAUSA) is the largest private and independent cardiology network in the United States. Our inclusive and diverse network brings together top cardiovascular specialists and thought leaders who offer regional perspectives and a broad strategic vision for the future of patient care. At CVAUSA, we are building a forward- thinking network of independent, entrepreneurial cardiologists dedicated to improving quality of care, lowering total costs of care, and being on the forefront of efforts to innovate and develop new treatments that improve lives. The CVAUSA network currently spans 23 distinct practices across 8 states, and CVAUSA clinicians collectively serve more than 750,000 unique patients annually.
POSITION SUMMARY:
The Charge Entry & Billing Specialist is responsible for the accurate entry, review, and validation of professional charges to ensure compliant claim submission and timely reimbursement. This role supports revenue cycle operations by ensuring services are coded appropriately, claims are submitted accurately, and billing edits are resolved prior to claim submission.
The position works closely with clinical staff, coding resources, and revenue cycle leadership to maintain revenue integrity, minimize claim rejections, and support optimal first-pass claim acceptance.
DUTIES AND RESPONSIBILITIES:
Charge Entry & Coding Validation
Performance Accountability / Key Performance IndicatorsThe Charge Entry & Billing Specialist is responsible for the accurate entry, review, and validation of professional charges to ensure compliant claim submission and timely reimbursement. This role supports revenue cycle operations by ensuring services are coded appropriately, claims are submitted accurately, and billing edits are resolved prior to claim submission.
The position works closely with clinical staff, coding resources, and revenue cycle leadership to maintain revenue integrity, minimize claim rejections, and support optimal first-pass claim acceptance.
DUTIES AND RESPONSIBILITIES:
Charge Entry & Coding Validation
- Enter professional charges into the practice management system in an accurate and timely manner.
- Validate CPT, HCPCS, and ICD-10 coding for accuracy and completeness prior to claim submission.
- Ensure required modifiers, rendering providers, locations, and POS codes are applied appropriately.
- Review documentation to ensure services billed are supported by the medical record.
- Identify and escalate coding discrepancies or documentation gaps to appropriate clinical or coding resources.
- Prepare and submit claims to payers in accordance with established billing timelines.
- Review and resolve system edits and claim scrubbing alerts prior to claim submission.
- Ensure claims meet payer guidelines for medical necessity and coding requirements.
- Monitor charge lag and claim submission timelines to support revenue cycle performance.
- Maintain compliance with payer regulations, CMS guidelines, and organizational policies.
- Support revenue integrity initiatives by identifying trends in billing errors, rejections, or missing information.
- Assist with internal audits and documentation review to ensure billing compliance.
- Participate in process improvement initiatives to improve charge capture accuracy and efficiency.
- Charge Entry Accuracy Rate
- Timeliness of Charge Entry & Claim Submission
- Claim Rejection / Edit Rate
- First-Pass Claim Acceptance Rate
- Charge Lag (Days from DOS to Charge Entry)
- Rework or Correction Rate
QUALIFICATIONS AND SKILLS:
Experience
- 2–4 years of experience in medical billing, charge entry, or revenue cycle operations.
- Experience working in a physician practice or specialty clinic preferred.
- Experience with AthenaOne, NextGen, eClinicalWorks, or similar practice management systems preferred.
- Knowledge of ICD-10-CM, CPT, and HCPCS coding standards
- Understanding of medical billing workflows and claim submission processes
- Familiarity with claim scrubbing edits and payer billing requirements
- Strong attention to detail and accuracy
- Ability to work independently while meeting productivity standards
EDUCATION:
- High school diploma or equivalent required.
- Associate degree in healthcare administration, medical billing, or related field preferred.
- Professional certification such as CBCS, CPB, CCA, or CCS is preferred but not required
BENEFITS:
- 401(k)
- Health insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance
**THIS IS A REMOTE WORK FROM HOME POSITION***
