Revenue Cycle Management Analyst III, Patient Financial Services

Organization:

SMF-Sutter Med Foundation- Central

Position Overview:

Ensures accurate and appropriate outpatient medical coding and documentation through coaching, training, and monitoring of clinicians. Monitors training success through encounter audits and ensures corrective action plans are implemented and adhered to. Serves as the local expert on Official Coding and Documentation Guidelines and other internal and external regulatory requirements (e.g. Centers for Medicare & Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), etc.).

Job Description:

EDUCATION:

• Equivalent experience will be accepted in lieu of the required degree or diploma.
• Bachelor's: Business Administration, Public Health, Finance, or related field

TYPICAL EXPERIENCE:

• 5 years of recent relevant experience.

SKILLS AND KNOWLEDGE:

• Advanced knowledge of the ICD-10-CM and CPT-4 Classification systems, HCPCS, and Evaluation and Management coding guidelines and thorough understanding of the effect of data quality on prospective payment, utilization, and reimbursement for multiple medical professional service specialties.
• Proficient understanding of the National Correct Coding Initiatives edits (NCCI) and ICD-CM Official Guidelines for coding and reporting.
• Ability to conduct coding audits and using the findings to create written reports with recommendations; and present education and feedback to facilitate improvement of documentation and coding.
• Working knowledge of relevant federal and state regulations, Medicare and Medicaid guidelines and compliance issues.
• Time management and project management skills.
• Working knowledge of microsoft office applications including word, excel, and powerpoint.
• Ability to work with and maintain confidentiality of physician, patient, patient account, and personal data.

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Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

As Needed

Benefits:

Yes

Unions:

No

This position is work from home eligible.

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

0

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $36.59 to $54.89 / hour

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

Qualified applicants with arrest and conviction records will be considered for employment. Applicants for specific positions are still required to disclose certain convictions during the application process, and those convictions may also be considered in determining eligibility for employment in accordance with applicable law.

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