Revenue Integrity Auditor

November 5

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Marshall Group

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501 - 1000

Description

• Works independently performing program, compliance, and risk-based reviews of health care related activities • Ensures accuracy of related medical record documentation, proper charge capture, ICD10 and CPT assignment, and billing in accordance with policies and reimbursement principles • Provides written audit summary of findings to include audit recommendations • Conducts revenue cycle investigations to determine and mitigate risk through findings, reports, and recommended actions • Responsible for coordinating, developing, and conducting educational training based on audit outcomes • Assists Corporate Compliance in maintaining the hospital's Corporate Compliance Program

Requirements

• Experience with Health Information Management (HIM), Facility/Physician Billing, Charge Description Master (CDM), Denials Management, Charge Integrity, Financial Analysis • Associate's/Technical Degree or equivalent combination of education/related experience: Required • Bachelor's Degree: Preferred • Five years' experience in healthcare coding inpatient, outpatient, rural health care and/or professional fee services: Required • Five years' experience in auditing in clinic and/or facility revenue cycle: Preferred • Certified Coding Specialist (CCS) or Certified Coding Specialist, Physician (CCS-Phy) or Certified Professional Coder (CPC) or Certified Professional Coder – Hospital (CPC-H) or Certified Coding Associate (CCA) • Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT): Required • Professional Medical Auditor (CPMA) or Certified E&M Coder (CEMC) or Certified E&M Auditor (CEMA) or Certified Documentation Integrity Practitioner (CDIP) or Certified Clinical Documentation Specialist- (CCDS): Preferred