Billing and Coding Auditor (REMOTE)
Auditor, Revenue Optimization
The Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding/ billing issues, participating in external/internal audit requests, payer audits, and special projects as needed.
This is a virtual position, but we prefer candidates to be based in one of the following locations: Audit medical records 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.
Retrieves 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 recommendation, 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
Retrieve or request necessary documents, code for billing, and data entry.
Provide coding support to cross-functional team inquiries and special projects.
Minimum 3 years coding experience.
Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
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)
Previous coding experience within Anesthesia or General Surgery.
Clinical Documentation compliance and regulatory requirements.
Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts/Health Savings Accounts
Apply tot his job
Apply To this Job
The Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding/ billing issues, participating in external/internal audit requests, payer audits, and special projects as needed.
This is a virtual position, but we prefer candidates to be based in one of the following locations: Audit medical records 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.
Retrieves 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 recommendation, 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
Retrieve or request necessary documents, code for billing, and data entry.
Provide coding support to cross-functional team inquiries and special projects.
Minimum 3 years coding experience.
Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
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)
Previous coding experience within Anesthesia or General Surgery.
Clinical Documentation compliance and regulatory requirements.
Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts/Health Savings Accounts
Apply tot his job
Apply To this Job