Senior Analyst, Coding Revenue Capture

Posted Yesterday
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Saint Paul, MN, USA
In-Office
Senior level
Healthtech • Information Technology
The Role
Analyze charge capture, work queues, and payer denials to identify trends, root causes, and financial impact. Monitor and resolve coding and charge master work queues, run queries and reports (pivot tables), advise clinicians and departments on coding/charging improvements, and collaborate across coding, denial management, operations, and compliance to drive revenue integrity.
Summary Generated by Built In

Park Nicollet is looking to hire a Senior Analyst, Coding Revenue Integrity to join our team!  Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. 

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:

Education, Experience or Equivalent Combination:

  • 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 

Knowledge, Skills, and Abilities:

  • 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. 
  • This position requires working with challenging customers daily. 
  • Proven efficiency in the operation of the following: personal computer, fax machine, copy machine and reference material.
  • Knowledge of Excel and spreadsheet capability.

Preferred Qualifications:

Education, Experience or Equivalent Combination:

  • Related 2-year associate degree or higher preferred.

Knowledge, Skills, and Abilities:

  • Knowledge of Oracle or other relational data base preferred.

Benefits:

Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!

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.

Skills Required

  • Minimum 2-3 years experience in healthcare revenue cycle and direct coding and/or charge master application experience
  • Previous experience working with denied charges related to professional and/or hospital services
  • Certified Coding Specialist or equivalent certification
  • Ability to determine appropriate CPT and ICD-10 code assignment; strong analytical and problem-solving skills
  • Excellent communication skills and ability to work independently and prioritize tasks
  • Proven efficiency with personal computer and office equipment; knowledge of Excel and spreadsheet capability (including pivot tables)
  • Related 2-year associate degree or higher
  • Knowledge of Oracle or other relational database
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The Company
HQ: Bloomington, MN
5,537 Employees
Year Founded: 1957

What We Do

HealthPartners, an integrated health care organization providing health care services and health plan financing and administration, was founded in 1957 as a cooperative. It's the largest consumer governed nonprofit health care organization in the nation – serving more than 1.8 million medical and dental health plan members nationwide. Our care system includes a multi-specialty group practice of more than 1,800 physicians that serves more than 1.2 million patients. HealthPartners employs over 26,000 people, all working together to deliver the HealthPartners mission. For more information, visit our company site at https://www.healthpartners.com or our career site at https://www.healthpartners.com/hp/careers.

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