Charge Audit Analyst at Sutter Health

Clayton, Missouri, United States -

Full Time

Start Date

Immediate

Expiry Date

27 Feb, 26

Salary

62.18

Posted On

29 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Terminology, Disease Processes, Patient Health Record Content, Medical Record Coding Process, Anatomy, Physiology, Pharmacology, Billing Functions, Revenue Cycle Applications, Project Management, Interpersonal Skills, Electronic Medical Records, Microsoft Office, Problem Solving, Investigative Skills, Communication Skills

Industry

Description

We are so glad you are interested in joining Sutter Health! Organization: S3-Sutter Shared Services-Valley Position Overview: 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. Job Description: EDUCATION: High School Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CPC-Certified Professional Coder OR COC-Certified Outpatient Coder OR RHIA- Registered Health Information Administrator OR RHIT- Registered Health Information Technician TYPICAL EXPERIENCE: 5 years recent relevant experience SKILLS AND KNOWLEDGE: 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. Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: None Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $34.25 to $51.38 / hour. California, New Jersey, and Washington Pay Range is $41.45 to $62.18 / hour. Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Texas, and Virginia Pay Range is $37.31 to $55.97 / hour. Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, South Carolina, Tennessee, and Utah Pay Range is $33.16 to $49.75 / hour. The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

Responsibilities

The Charge Audit Analyst is responsible for improving the accuracy of outpatient clinical documentation coding and charging. This includes providing education to clinical departments and coding staff and addressing root causes to ensure compliance with policies.