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 years9 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!