Charge Audit Analyst

Sutter Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare organization is seeking a Clinical Documentation Analyst responsible for ensuring the accuracy of outpatient clinical documentation coding. The role requires collaboration with clinical departments to improve coding practices and comply with policies. Candidates should possess a high school diploma and relevant certifications such as CPC or RHIA, with at least 5 years of experience in the field. The position offers competitive compensation and supports educational initiatives.

Benefits

Comprehensive benefits package

Qualifications

• 5 years recent relevant experience.
• Knowledge of Medicare APC and OPPS reimbursement structures.

Responsibilities

• Improve the accuracy of facility outpatient clinical documentation coding.
• Assist clinical areas to document services effectively.

Skills

Knowledge of medical terminology

Basic knowledge of anatomy

Familiarity with billing functions

Ability to work concurrently on diverse tasks

Understanding of hospital-based outpatient charging

Proficient with Microsoft Office

Education

High School Diploma or GED

Tools

Electronic medical records (EPIC preferred)

Job description

Overview

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
• COC - Certified Outpatient Coder
• RHIA - Registered Health Information Administrator
• 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, HCPCS/CPT, 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 Details

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.