Integrity and Compliance Coding Analyst

HealthPartners; BLOOMINGTON (MN); On-site; USD 70,000 - 100,000; Full time

Job summary

HealthPartners in Bloomington, MN seeks an Integrity and Compliance Coding Analyst to review documentation, coding, and billing for compliance risk and regulatory adherence. You will collaborate with clinical and operational teams to communicate findings and support remediation efforts.

Responsibilities include analyzing review results, preparing clear reports, and developing corrective action plans to strengthen revenue integrity across the organization.

Qualifications

• Certified coder with five or more years of relevant experience or a bachelor’s degree in a related field.
• Proven ability to conduct documentation, coding, and billing reviews for compliance.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and payer requirements.

Responsibilities

• Conduct documentation, coding, and billing reviews to identify compliance risks.
• Analyze findings, prepare summaries and reports for leadership.
• Develop corrective action plans and monitor remediation activities.

Skills

Analytical skills

Investigative skills

Problem-solving

Communication skills

Prioritization

Education

Bachelor's degree in a related field

Certified coder (CPC/CCS/RHIT/RHIA/CPMA) or equivalent

Job description

Job Description

HealthPartners is hiring an Integrity and Compliance Coding Analyst. They are responsible for conducting documentation, coding, and billing reviews to identify, reduce, and mitigate compliance-related risk. This role evaluates medical record documentation, coding accuracy, and billing practices to ensure adherence to regulatory requirements, payer policies, and organizational standards. The position collaborates closely with operational and clinical partners to communicate findings, recommend corrective actions, and support ongoing compliance and revenue integrity efforts.

HealthPartners is hiring an Integrity and Compliance Coding Analyst. They are responsible for conducting documentation, coding, and billing reviews to identify, reduce, and mitigate compliance-related risk. This role evaluates medical record documentation, coding accuracy, and billing practices to ensure adherence to regulatory requirements, payer policies, and organizational standards. The position collaborates closely with operational and clinical partners to communicate findings, recommend corrective actions, and support ongoing compliance and revenue integrity efforts.

Key Responsibilities

Core Reviews

• Conduct medical documentation, coding, and billing reviews to identify compliance concerns and areas of potential risk.
• Analyze review findings, investigate billing issues, and prepare clear summaries and reports.
• Develop, support, and monitor corrective action plans to address identified deficiencies and improve compliance outcomes.
• Ensure effective communication and handoff of review results, recommendations, and remediation activities.

Regulatory Expertise

• Apply knowledge of ICD-10-CM, CPT, HCPCS, Medicare, Medicaid, commercial payer requirements, and healthcare billing regulations.
• Stay current on documentation, coding, billing, and regulatory changes impacting healthcare organizations.
• Evaluate the quality, accuracy, and consistency of review findings.
• Ensure effective communication and handoff of review results, recommendations, and remediation activities.

Collaboration

• Partner with clinical providers, revenue cycle teams, health information teams and other operational teams
• Present findings and recommendations to leadership and support education related to documentation, coding, and billing compliance.
• Foster a culture of compliance through collaboration, consultation, and problem-solving.

Continuous Improvement

• Identify opportunities to improve audit methodologies, monitoring activities, and reporting processes.
• Recommend innovative approaches to strengthen compliance monitoring and risk mitigation programs.

Qualifications

Education

• Certified coder (CPC, CCS, RHIT, RHIA, CPMA, or equivalent) with five or more years of relevant experience, and/or a bachelor's degree in a related field.

Experience

• Demonstrated experience conducting documentation reviews, coding audits, billing investigations, and compliance assessments.
• Strong understanding of medical terminology, anatomy and physiology, disease processes, clinical documentation, and healthcare reimbursement.

Skills

• Strong analytical, investigative, and problem-solving abilities.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and communicate effectively with leaders and stakeholders across the organization.