Senior Analyst, Coding Revenue Capture
Position Summary
Highly skilled individual within Revenue Cycle or Charge Master who can independently analyze and understand large amounts of moderately complex data to identify trends, root causes and financial impacts related to charge capture, work queue (WQ) activities, and payer denials. Responsible for monitoring WQs (Charge Master, coding, and/or denial-related) to ensure timely resolution, appropriate routing, and compliance with organizational standards. Analyzes, prepares, and delivers findings on denied charges and charge discrepancies to stakeholders, with a focus on identifying systemic issues impacting revenue and operational workflows. Develops an understanding of the third-party payer denials as they relate to professional charges to ensure appropriate payment.
Provides pertinent guidance and expertise within work queue management, charge trending, and research of denials that pertain to coding rules, payer policies and government regulations. Independently monitors volumes, aging and financial impact of coding denials and WQ inventory. along with dollars associated with coding denials to provide direction and assistance to the coding team. Independently runs queries, coordinates pivot tables, and/or other reports for leaders. This can include information on identified trends, issues, and/or provides input and support to medical departments on decreasing denials and capturing appropriate revenue by researching how clinician/departments can improve how they charge or code and make suggestions to the operational issues that contribute to the denials the department/clinician may be incurring.
A highly visible role that collaborates across coding, charge master, denial management, operational departments and Integrity and Compliance to drive revenue integrity, reduce variation, and support system wide best practices.
Required Qualifications
- Minimum 2-3 years’ experience in health care working with the many different aspects of the revenue cycle as well as direct coding and/or charge master application experience required.
- Previous experience working with denied charges as it relates to professional and/or hospital services is necessary.
- Licensure/ Registration/ Certification: Certified Coding Specialist or equivalent certification required
- Detail oriented, organized individual with the ability to discern the nature of the procedure and method used to determine appropriate CPT and ICD-10 code assignment.
- Must be able to prioritize tasks and work independently as well as on team projects.
- Strong problem solving, decision making, and analytical skills are critical.
- Must have excellent communication skills and leadership qualities.
Preferred Qualifications
- Related 2-year associate degree or higher preferred.
- Knowledge of Oracle or other relational data base preferred.
About Us
Park Nicollet is 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
At HealthPartners, 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.