SR REVENUE AUDITOR/ FULL-TIME/ 80 HRS PER PAY PERIOD
This position contributes to the systems revenue integrity by maintaining the Hospital CDM and ensuring all new and existing charge codes are setup with the appropriate CPT and revenue center codes according to government and third party payer regulations. Responsible for the annual review of changes to CPT/HCPCS codes and provides education and in-service training to clinical departments to ensure appropriate charging patterns. Processes CDM requests to ensure that all additions, changes, and deletions are consistent with proper charging, billing, and coding practices.
Researches and resolves charging issues to ensure timely billing and works with moderately complex clinical systems, departments and practices, which requires strong interpersonal and communication skills, well-developed organizational skills, and the ability to meet deadlines and influence others. Performs comprehensive reviews with clinical departments to ensure completeness and accuracy of charge description master. Takes initiative to independently identify system and/or operational problems and participates in the development of solutions for improving billing functions. Completes chart to bill audits as needed.
Education
Minimum Level of Education Required: Associate degree
In lieu of degree, 1-3 years’ experience in related field
Additional requirements:
Type of degree: Health Information Management or Nursing Degree Preferred
Experience
Minimum Level of Experience Required: 1 - 3 years of job-related experience
Prior job title or occupational experience: Minimum of 2 years’ experience in revenue cycle or reimbursement
Other experience requirements:
Understanding of Medicare & Medicaid regulations is required
In depth knowledge of compliance regulations as they relate to documentation, coding, and billing requirements.
Demonstrated ability to train and educate all levels of the organization is required.
Functional knowledge of hospital operations in direct patient care and support departments is required
Current knowledge of hospital billing is required.
Current knowledge of how the charge description master files directly impact the revenue cycle process
Knowledge/Skills
- Possess a desire to lead and provide support and accountability to co-workers and internal customers.
- Able to work independently and as part of a team
- Comprehensive understanding of Microsoft Office product
- Effective at adjusting to change, prioritizing duties, and handling stress
- Project management skills and experience working with integrated teams is preferred
- Strong written and oral communication skills required
- Ability to research and evaluate information
- Understanding of how to manage both clinical and financial data elements
- Strong interpersonal skills necessary to interact with all departments
- Ability to work and contribute to a team environment
- Ability to promote a positive and safe environment through encouragement, consideration, enthusiasm, respect, humor and tact.
