Charge Audit Analyst

St. Croix Regional Medical Center

Introduction:

St. Croix Regional Medical Center is currently seeking a 1.0FTE Charge Audit Analyst. This position will work a hybrid remote schedule Monday-Friday 7:30am-4:00pm.

The Charge Audit Analyst is responsible for auditing workflows and documentation to ensure compliant charge capture throughout the organization, while maintaining integrity with The Centers for Medicare and Medicaid Services (CMS) and other regulatory agencies. This position serves as a liaison between clinical processes and revenue cycle, conducts research and analysis, bench marking, and analyzes data to ensure the accuracy of information. The Charge Audit Analyst will maintain knowledge of the various regulatory agency guidelines and assure requirements are met along with accurate, complete, and timely charge processes.

Job Description:

  1. Audits and analyzes charges being captured by hospital departments for accuracy and completeness
    • Analyzes findings for improvement opportunities
    • Ensures that appropriate revenue is captured based on documentation from providers and nursing
  2. In collaboration with leadership, identifies and implements best practices of charge capture through quality audits
    • Develops education plans to assist service line leaders in achieving optimal reimbursement
    • Recommends new categories for revenue capture
  3. Monitors government and commercial payers for updates and changes to billing requirements
    • Communicates with and educates hospital and administrative staff on any actions required to comply with regulations
  4. Participates in chargemaster (CDM) maintenance efforts
    • Reviewing charges to accurately reflect provided services/supplies
    • Ensure charges are consistent with industry regulations and best practices
  5. Develop individualized educational plans
    • Improve provider accuracy where deficits are identified through internal or regulatory audits
  6. Facilitates appropriate modifications to documentation
    • Interact and collaborate with physicians, coding, case management, nursing and other care givers to ensure appropriate documentation
  7. Performs all duties and responsibilities in accordance with ethical and legal business procedures
    • Compliant with federal and state statutes and regulations, official coding rules, guidelines and accepted standards of coding practice including appropriate clinical documentation policies
  8. Responsible for training hospital departments
    • Ensure compliant charge practice, annual CPT/HCPCS code updates, and charge capture improvement
  9. Serves as subject matter expert related to charging and billing issues
    • Assists in developing and maintaining revenue capture related policies and procedures
  10. Performs root-cause analysis for system related charge capture failures.
    • Works in collaboration with Excellian IT support and department staff to ensure charge capture functionality is optimized and efficient

While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add or remove duties from particular jobs and to assign other duties as necessary.

Experience:

  • Minimum three years healthcare experience, required. Five years healthcare experience, preferred.
  • Minimum of three years chargemaster, billing, or coding experience, required.
  • Clinical Documentation Integrity experience, preferred.
  • Epic experience, preferred

Education & Licensure:

  • Associate’s degree in Business Administration, Healthcare Administration, Health Information Management, or Finance, required.
  • Bachelor’s degree in Business Administration, Healthcare Administration, Health Information Management, or Finance, preferred.
  • Coding Certification (AHIMA or AAPC), preferred.

Compensation/Benefits:

Here at St. Croix Regional Medical Center we offer our employees with a robust benefits package that includes:

  • Health, vision and dental insurance
  • 403b retirement program with employer match
  • Paid time off
  • Short-term disability, long-term disability and life insurance options
  • Education reimbursement
  • Employee assistance program (EAP)
  • Wellbeing incentive program
  • Free parking
  • Employee prescription discount program

Instructions for Resume Submission:

Please go to our website to apply, www.scrmc.org.

Apply Online: http://www.scrmc.org