Charge Audit Analyst, Cardiac Cath and IR

Sutter Health • Sacramento, CA

1d

About The Position

The Charge Audit Analyst is responsible for activities that improve the accuracy of facility outpatient clinical documentation coding and charging. This includes providing education to clinical departments and coding staff, as well as performing root cause correction to ensure accurate charging and coding in compliance with established policies. The analyst also assists clinical areas in effectively documenting services and understanding the relationship between documentation and charging for services provided, all 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 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.

Nice To Haves

• Experience with cardiac cath and interventional radiology facility charging/coding preferred
• Electronic medical records (EPIC preferred)

Responsibilities

• Improve the accuracy of facility outpatient clinical documentation coding and charging.
• Provide education to clinical departments and coding staff.
• Perform root cause correction to support accurate charging and coding in compliance with policies.
• Assist clinical areas in effectively documenting services.
• Help clinical areas understand the relationship of documentation and charging for services provided in accordance with policies and procedures.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees