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Sutter Health · 8 hours ago

Charge Audit Analyst

Sacramento, CA

Full-time

Onsite

Senior Level

$34.25/hr - $51.38/hr

5+ years exp

Sutter Health is seeking a Charge Audit Analyst to improve the accuracy of facility outpatient clinical documentation coding and charging. The analyst will work with clinical departments and coding staff to ensure compliance with policies and provide education on effective documentation practices.

Health CareHospitalNon Profit

Comp. & Benefits

Responsibilities

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

Qualification

CPC CertificationRHIA CertificationMedical Coding KnowledgeRevenue Cycle KnowledgeElectronic Health Record SystemsMedical TerminologyAnatomy KnowledgeBilling Functions FamiliarityInterpersonal SkillsProject Management SkillsOrganizational SkillsProblem Solving SkillsCommunication Skills

Required

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