Charge Master Coding Analyst

Regions Hospital; Saint Paul (MN); On-site; USD 80,000 - 105,000; Full time

Job summary

Regions Hospital is seeking a Charge Master Coding Analyst to compare medical records documentation with billed items and identify coding and billing issues. The role analyzes department charging patterns, updates preference lists, and reports audit outcomes to improve revenue capture across hospital departments.

The position requires a HIM-related degree and CPC/RHIT/RHIA certifications, with 5+ years hospital experience and 3+ years in coding/billing.

Qualifications

• 5 years minimum hospital experience.
• 3 years’ experience in coding, billing, and/or patient accounting.
• Degree in HIM or related field; CPC or RHIT/RHIA acceptable.

Responsibilities

• Audit the chargemaster and coding for accuracy and compliance.
• Review CPT, HCPCS and ICD-10 codes across departments and implement changes.
• Create and update CPT/CCP/edit lists and department preference lists.
• Provide guidance and training to coders; collaborate with nursing, finance and patient accounting.
• Develop and reports on audit outcomes; monitor revenue capture improvements.

Skills

Medical terminology

Coding guidelines

Investigative ability

Interpersonal communication

Organization skills

Independent work / prioritization

Education

Degree in HIM / related field

CPC certification

RHIT / RHIA certification

Tools

EPIC

Charge Master systems

Job description

Job Description

Regions Hospital is hiring a Chare Master Coding Analyst. Uses clinical knowledge and experience to compare the medical records documentation to the individual items billed. Analyzes departments charging patterns and identifies coding and billing issues. Reviews and updates preference lists and ensures their accuracy. Provides a summary of any yearly coding changes that could impact each department. Coordinates and reports audit outcomes regarding charge errors, data processing errors, and the performance of hospital charging system. Schedules annual visits with Regions areas to address any chargemaster issues. Works directly with clinical areas regarding missing or misdirected charges and acts as a resource to assist with charging and coding issues that occur. Uses own initiative to organize work and set priorities/meet deadlines and complete assignments. Offers guidance to team members by assisting with workflow management and questions. Works closely with medical records, nursing departments, finance and patient accounting. Audits charge master details for individual departments; spot check coding compliance, revenue capture review, troubleshoots problem codes. Special projects to improve revenue cycle outcomes. Assists the chargemaster manager with training, coding and billing research and special projects. Performs other duties as assigned.

Education

Degree in HIM, Business Administration or any Medically related field and/or Certified Professional Coder (CPC).

Experience

• 5 years minimum hospital experience
• 3 years’ experience in coding, billing, and/or patient accounting

Knowledge, Skills & Abilities

• Knowledge of medical terminology
• Knowledge of coding guidelines
• Investigative ability
• Ability to relate to many levels, such as patients, nurse auditors, and employees throughout all hospital departments.
• Excellent communication and organizational skills.
• Ability to work independently, prioritize tasks and problem-solve.

Licensure / Registration / Certification

Coding certification, such as CPC (Certified Professional Coder), or Health Information Management Certification such as RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator).

Major Job Duties And Tasks

• Annual Auditing 50%
• Auditing of individual Hospital department charge masters. These tasks are teamed with Charge Master Manager.
• On schedule or per department request compiles charge master.
• Reviews with Charge Master Manager all charges and updates, compliance memos, CCI edits.
• Reviews with nurse manager/coder charging mechanism, makes suggestions for compliance, charge ticket or preference list updates.
• Reviews and updates CPT, HCPC and ICD-10 codes for individual departments, communicates and educates departments on upcoming changes prior to implementation.
• Provides summary report on action taken to nurse manager, department coders, Patient Accounting file.
• Evaluates information from daily Charge Capture Audit system 10%
• Reviews monthly bill analyzer report to identify possible missed revenue and coding errors.
• Works with clinical departments to identify and restore missing charges and builds edits in EPIC to prevent future missed charging.
• Assists in facilitating conversations with chargemaster groups across all facilities to identify trends and implement system fixes for all hospitals.
• Maintains vendor relationships with Charge Capture Audit System vendor, including a system support relationship, for troubleshooting, expansion, coding compliance.
• Nurse/Department charge Audits 5%
• Performs defense auditing of targeted medical records in conjunction with the itemized bills for charging errors, sub-standard documentation and inaccurate procedural billing.
• Obtains medical records and conducts a pre-audit. Resolves as many discrepancies as possible.
• Memos the account on action taken.
• Reports audit results to departments along with recommendations for future education and training.
• Special Project Management 15%
• Prepares reports as required by management regarding audit results, process improvement recommendations, systemic billing errors, and documentation concerns.
• Performs individual account review as requested.
• Reviews code usage as requested.
• Provides back up coding support as needed for coders
• Creates CDMs as requested by departments.
• Reviews CDM requests for coding compliance.
• Billing Clarification Management 15%
• Reviews Billing Clarification requests from Billing Team.
• Sends appropriate communication to department contact.
• Reviews coding related billing denials and provides direction to billing department on how to appeal.

About Us

At HealthPartners we believe in the power of good - good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed To Support Your Total Health

As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients, members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.