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Charge Capture Representative information

What is a charge capture representative?

A Charge Capture Representative is a healthcare professional responsible for ensuring that all services provided to patients are accurately documented and billed. They review medical records, physician notes, and other clinical documentation to identify billable procedures and services. Their work helps healthcare facilities maximize reimbursement and maintain compliance with billing regulations. Charge Capture Representatives play a crucial role in the revenue cycle by minimizing missed charges and reducing the risk of billing errors.

What are the key skills and qualifications needed to thrive as a charge capture representative?

To thrive as a Charge Capture Representative, you need a solid understanding of medical billing, coding practices, and healthcare reimbursement systems, often supported by a relevant associate degree or certification such as CPC (Certified Professional Coder). Familiarity with hospital information systems (HIS), electronic health records (EHRs), and coding software like ICD-10 and CPT is typically required. Attention to detail, analytical thinking, and effective communication are vital soft skills for ensuring accurate charge entry and collaboration with clinical staff. These skills are crucial for ensuring proper revenue capture, compliance with regulations, and minimizing billing errors in healthcare organizations.

What are some common challenges faced by charge capture representatives, and how can they be addressed?

Charge Capture Representatives often encounter challenges such as missing or incomplete clinical documentation, coding discrepancies, and keeping up with frequent regulatory changes. To address these, it’s essential to maintain proactive communication with clinical staff and coders, regularly attend training sessions, and utilize audit tools to ensure accuracy. By developing strong attention to detail and staying organized, Charge Capture Representatives can help minimize errors and improve the efficiency of the revenue cycle.

What is the difference between Charge Capture Representative vs Medical Billing Specialist?

AspectCharge Capture RepresentativeMedical Billing Specialist
CredentialsHigh school diploma; certification preferredHigh school diploma; certification often preferred
Work EnvironmentHospitals, clinics, outpatient facilitiesMedical offices, billing companies, healthcare facilities
Job FocusAccurately capturing charges at point of careProcessing and submitting claims, managing payments

While both roles are essential in healthcare revenue cycle management, a Charge Capture Representative primarily focuses on recording charges accurately during patient care, whereas a Medical Billing Specialist handles the claims process and payment collections. Understanding these differences helps healthcare providers optimize billing workflows and ensure proper reimbursement.

What are popular job titles related to Charge Capture Representative jobs in California?

For Charge Capture Representative jobs in California, the most frequently searched job titles are:

What job categories do people searching Charge Capture Representative jobs in California look for?

The top searched job categories for Charge Capture Representative jobs in California are:

What cities in California are hiring for Charge Capture Representative jobs?

Cities in California with the most Charge Capture Representative job openings:

Charge Capture Representative jobs near you
Infographic showing various Charge Capture Representative job openings in California as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Practice Coordinator III

University of California San Francisco

Emeryville, CA

$27.75 - $31.75/hr

Full-time

Medical, Dental

Re-posted 11 days ago

University Of California San Francisco rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

229th of 618 rated colleges and universities

Job description

As a patient-focused organization, UCSF Medical Center exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. UCSF Medical Center seeks faculty and staff that are committed to the values of professionalism, respect, integrity, diversity, and excellence that are integral to our mission. 

The PC Authorization Coordinator is primarily responsible for securing financial clearance for the patient, provider, and health system. The coordinator works closely with the administrative, clinical and management teams to support practice operations and customer service recovery and intervention efforts. Provides support for financial clearance functions including authorizations, PAFRs, LOAs billing and RFIs.     

Under the direction of the Revenue Manager and/or supervisor, the biller/auth rep will work independently to resolve billing related issues in APeX (Epic) to help maximize payor reimbursement and RVU charge capture. He/she must have an advanced understanding of healthcare terminology, processes and workflow and healthcare billing/authorizations in order to make good decisions and resolve account issues. The incumbent should also have outstanding people skills, including telephone technique, professional appearance, organizational skills, and communication skills (oral and written). 

This position will also be responsible for performing detailed review of medical record documentation to answer billing/authorization level questions and will be responsible for working assigned authorization and billing work queues (WQs) on a daily basis to assist in keeping the denials at a minimum. He/she must have the ability to prioritize multiple tasks and work well with all levels of staffing including faculty, management, and coworkers both within and outside of the unit. 

The PC is responsible for the maintenance of all routine clerical operations and communications.  Adheres to the UCSF House and Telephone Standards and is sensitive to the needs of patients, staff and providers at all times.  The PC is a team player who works closely with others and who is flexible in dealing with the changing priorities.  Requires a self-reliant individual who synthesizes knowledge of practice operations in order to problem-solve, prioritize and facilitate complex transactions in the course of daily activities. 

This position makes a difference for patients in an outpatient care unit by providing excellent customer service, facilitating and ensuring the accuracy of the information flow between medical, hospital staff and departments to maximize unit efficiency. The PC is required to work at any UCSF campus as needed and scheduled. 

About UCSF

The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world's leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available here.

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

Salary Information

The final salary and offer components are subject to additional approvals based on UC policy.

Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.

To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

REQUIRED 

  • High School graduate or equivalent with four years related experience; or college degree and 6 months related experience; or equivalent combination of education and experience.   

  • Successfully passes fingerprinting protocol and is approved to be a cash collector if applicable. 

  • Strong computer skills, including basic keyboarding skills, and experience with at least two Officetype software programs (i.e., Outlook, Word and Excel). Proven ability to navigate through multiple patient records systems. Able to sit at a computer terminal with telephone headphones for extended period of time. 

  • Ability to analyze situations, prioritizes, and develops solutions and makes recommendations. 

  • Ability to work with minimal supervision 

  • Ability to use good judgment and work independently, at times under the pressure of deadlines 

  • Ability to access situations prioritizes workload, develop solutions and make recommendations. 

  • Excellent customer service and communication/interpersonal skills, both over the telephone and directly. 

  • Able to sit at a computer terminal with telephone headphones for extended periods of time. 

  • Basic math skills required. 

  • Proven ability to deal with a wide variety of individuals. 

  • Ability to deal sensitively and effectively with patients. 

  • Excellent organizational and problem-solving skills. 

  • Strong writing skills to include the ability to compose, edit, and proof a wide variety of documents. 

  • Demonstrated administrative/office coordination skills. 

  • Demonstrated knowledge of medical practice terminology. 

  • Within six months of start date, based upon completion of training, the Supervisor, completes the proficiency checklist with the employee. This includes the following areas if applicable 

o Complete moderate to complex authorization independently o Work applicable work queues o Right Fax o Use of Authorization/Certification Table o Ensure they have access to all Payer websites and can utilize all proficiently o Efficiently obtain authorizations within or exceeding productivity requirements o Review and verify benefits as needed; update in Apex o Staff message o Route authorization queries to practice (My Chart)   o Patient Schedule (My Chart) o Letters o Pools o Patient look up o Comment field o Quick note o Scanning 

 

Preferred Qualifications: 

  • Demonstrated experience in health care (may include medical, dental or veterinary) in the following areas:  patient scheduling, insurance verification, medical record data abstraction, or patient financial services. 

  • Prior experience with appointment, ancillary service or surgical scheduling or a combination of all three.   

  • Bi-lingual or multi-lingual capability (Spanish, Cantonese, and Russian) strongly preferred. 

  • Prior experience with EPIC. 

 

Required Licenses/Certifications: 

  • N/A 

DUTIES & ESSENTIAL JOB FUNCTIONS New & Follow-Up Patient Authorizations    5% 
  • On a daily basis review and works authorization work queues documenting activities within the authorization record.   

  • Reviews referral work queues as needed to monitor incoming volume. 

  • If a practice utilizes an external system for specialty authorizations, such an electronic log, the representative maintains the electronic log but also creates an authorization record for accurate tracking and documenting financial securitization. 

  • Enters or updates patient registration information as needed to correct errors. 

  • Ensure appropriate insurance is loaded and facilitates authorization acquisition. Verifies insurance and referral/authorization information from previous appointments as needed to facilitate subsequent authorizations. Schedules and coordinates any pre-appointment tests or appointments.   

  • Schedules and coordinates any pre-appointment tests or appointments. 

  • Creates HARs [Hospital Account Records] as needed to facilitate authorization loading. 

  • Creates a professional and positive first impression for patients and referring physicians.  Demonstrates good judgment and common sense. 

Advanced New & Follow-Up Patient Authorizations  15% 

  • Secures outside medical records, as needed for authorizations  makes quick determination on services known for long authorization turn around or not needing the authorization. as to which physician can best evaluate the patient. 

  • Understands and is able to prioritize authorizations based on clinical complexity, diagnosis and current treatment status to ensure authorizations are prioritized appropriately. Has expertise in understanding payor timelines to know when authorizations need to be started urgently due to payor constraints and ensure that as many patients are authorized successfully as possible.  
  • Informs practice personnel, providers are patients as needed of authorization delays and denials in a timely manner. 

  • Escalates authorization delays ASAP for services to patients within 72-hour window or for urgent or medically sensitive services. 

Surgical Authorization Coordinator 5 % * depends on practice 
  • Coordinates securing authorizations for all outpatient and inpatient surgeries for the surgical practice. 

Captures appropriate CPT and ICD-10 codes, or coordinates with provider, or certified professional coder to acquire accurate codes. 

  • Interacts with clinical and academic staff to coordinate surgical activities depending on authorization availability. 

  • Coordinates and manages complex referrals and authorizations including LOAs, Psych, Lab, Imaging and other specialties. 

Advanced Surgical Authorizations 15% 

  • Coordinates with practices, PAR, Admitting and other related departments to coordinate securing all necessary authorizations. This could include procedure, admissions, medications, labs, imaging and testing services. Additionally, many cases require complex admission, discharge and planning coordination involving hospital reservations and authorizations related to study patients on protocol, transfers from outside hospitals and post transfer urgent authorizations and surgical planning.   

  • Works with patients and staff to confirm availability and accuracy of medical information within APeX and to ensure documentation supports medical necessity.
  • Secures authorization for surgical procedures and coordinates with Hospital Admissions Department as needed. Acts as primary liaison to procedure billing team to coordinate updated authorizations and or TARs for mid procedure changes or additions. 
  • Ensures compliance with Medical Center bylaws and Regulations ensuring the diagnosis is confirmed before authorization through formal review of relevant clinical information.  The authorization coordinator is the sole person to ensure authorization is secured for the organization.   
  • Coordinates advanced authorization for complex services such as psychotherapy, psychiatry, IVF, serial service testing and imaging. 

  • Must have extensive payor expertise to coordinate complex authorizations for multiple surgical practices (i.e. Ortho Surgery, Urology Surgery etc.)  Revenue Cycle  <5% 

  • Ensure that authorizations are secured with accurate clinical information and with support for medical necessity. 
  • Communicates Medical Center administrative and financial policies clearly to patients, answering patient account questions and knowing when to refer patients to financial counseling, billing agents, patient relations or other support departments for additional help. 
  • Obtains and documents insurance authorizations for established patient visits, referrals and procedures or ancillary services. Communicates clinical information from medical records authorization requests to insurance companies.   
  • Demonstrates competency working with CPT codes and ICD-9 and ICD-10 for the purpose of scheduling and securing authorization. 
  • Works with patients and staff to confirm availability and accuracy of medical information within APeX and to ensure compliance with all hospital policies and procedures. 

  • Able to identify and escalate outstanding issues to appropriate supervisor or manager. 

  • Addresses patient billing questions and triage calls as needed. 


 

Provides requested documentation such as operative reports, doctor's notes and insurance information to aid in the reimbursement process. 

  • Obtains retro authorizations of procedures while maintaining current list of those insurances with a history of denials (this includes pre-service, post service, retro/modifications and appeals if needed.) 

Moderate Complex Revenue Cycle 5% 
  • Monitors provider(s) open authorizations to ensure that patie...

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