Job Title: Revenue Auditing Specialist
Job Description:
Our organization is seeking a highly skilled Revenue Auditing Specialist to join our team. In this role, you will be responsible for conducting thorough audits of clinical documentation to ensure accurate charge capture and billing in accordance with industry standards and compliance regulations.
You will work closely with cross-functional teams to identify and resolve coding and billing issues, participate in external and internal audit requests, payer audits, and special projects as needed. Your expertise in medical billing software and electronic medical records will be essential in ensuring the accuracy and efficiency of our revenue cycle processes.
Key Responsibilities:
* Audit clinical documentation to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities
* Perform root cause analyses and report findings that identify common issues, including over-coding, under-coding, and missed billing opportunities
* Retrieve any missing patient information and documentation required for billing
* Complete coding of unbilled records identified through audits
* Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes
* Assist with clinical documentation recommendations, coding guidance research, and the development of coding educational documents
* Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution
* Pre-payment audit: review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and/or identify CDI (Clinical Documentation Improvement) opportunities
* Provide resolution of missing documentation tasks. Retrieve or request necessary documents, code for billing, and data entry.
* Provide coding support to cross-functional team inquiries and special projects.
Required Skills and Qualifications:
* Minimum 3 years of coding experience
* Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
* Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment
* Extensive knowledge of medical billing software and electronic medical records
* Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the revenue cycle process
* Proficient PC skills, including Microsoft 365
* Excel proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables
Benefits:
* Generous benefits package, including paid time off, health, life, vision, dental, disability, and AD&D insurance
* Flexible spending accounts/health savings accounts
* 401(k)
* Leadership and professional development opportunities
Other Information:
This position is responsible for ensuring the accuracy and efficiency of our revenue cycle processes. If you are a detail-oriented and organized individual with excellent communication skills, we encourage you to apply for this exciting opportunity.
EEO Statement:
Our organization is an equal opportunity employer.