Charge Audit Analyst

Sutter Health•Centennial, CO

45d•$34 - $51

About The Position

Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. The analyst assists clinical areas to effectively document services and understand the relationship of documentation and charging for the services provided in accordance with policies and procedures.

Requirements

High School Diploma or General Education Diploma (GED)
CPC-Certified Professional Coder
OR COC-Certified Outpatient Coder
OR RHIA- Registered Health Information Administrator
OR RHIT- Registered Health Information Technician
5 years recent relevant experience
Knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
Basic knowledge of anatomy, physiology and pharmacology.
Familiarity with billing functions and the components of a charge description master.
General knowledge of Revenue Cycle applications, including Electronic Health Record systems.
Ability to work concurrently on a variety of tasks / projects in a fast-paced environment with identified productivity requirements and with individuals having diverse personalities and work styles.
Ability to comply with Sutter Health policies and procedures.
Ability to work with and maintain confidential information.
Understanding of hospital-based outpatient charging and coding
Knowledge of Medicare APC and OPPS reimbursement structures
In-depth knowledge of medical and billing terminology, common procedure terminology, diagnosis codes, healthcare common procedure coding system, and revenue codes.
Knowledge of government and/or commercial payer requirements.
Knowledge of Federal, State, and Local regulatory publications and how to access.
Knowledge of Outpatient National Correct Coding Edits.
Demonstrated ability to review a health record and determine applicable charges/codes for hospital/facility billing for a range of service lines.
Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.
Possesses strong project management skills.
Possesses strong interpersonal skills, with demonstrated success at communicating effectively with all levels of the organization, especially senior leadership and department heads.
Demonstrates skilled ability and comfort with electronic medical records (EPIC preferred) and hospital billing functions.
Proficient with Microsoft Office computer applications (Excel, Word, and PowerPoint).
Effective organizational skills with the ability to prioritize and manage multiple functions and responsibilities simultaneously.
Effective verbal and written communication skills, good listening skills, and the ability to interpret end users' needs.
Strong problem solving and investigative skills.