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Company

Trinity Health · 8 hours ago

Revenue Integrity Auditor Full-Time Days (REMOTE)

Boise, ID

Full-time

Remote

Mid Level

3+ years exp

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DeliveryHealth Care

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Responsibilities

Conducts departmental audits to ensure proper documentation and compliance with state and federal guidelines relating to the charge capture and billing of services.

Prepares and submits audit findings and makes recommendations to Revenue Integrity and Compliance.

Coordinates concurrent and retrospective audits of patient medical records and itemized bills.

Performs charge audits to ensure charging/coding accuracy provides feedback to department Revenue Leads and Management.

Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers), charging processes and audits, and clinical billing.

Reviews bulletins to maintain an understanding of regulatory and payer changes to assure correct charging and billing requirements are met.

Maintains working knowledge of coding and billing regulations for all payors.

Keeps current on regulatory updates.

Maintains working knowledge of local established policies, protocols, and procedures to ensure charge accuracy

Provides results and education to department managers and charge capture auditors.

Proficient in outpatient and inpatient charge capture operations and coding

Comprehension of revenue cycle operations

Maintains a positive relationships with all parties

Willingness to adjust competencies as necessary to meet requirements of position.

Ability to work with a wide variety of people under adverse conditions.

Strong communication skills.

Knowledge of charge capture, reconciliation, error management operations required.

Attends required training sessions on updates to billing regulations and/or charge capture process.

Proficient in use of MS Office applications (Word, Excel), Internet applications and Outlook

Excellent communication and organizational skills.

Qualification

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RHIA certificationRHIT certificationCPC certificationCCS certificationHealth care reimbursementMedicare coding knowledgeCPT codingHCPCS codingCharge capture knowledgeHospital business operationsICD-9 codingICD-10 codingCharge master maintenanceMS Office proficiency

Required

Bachelor's degree in Business preferred, or related field or equivalent experience/specialized education in hospital revenue cycle operations.

Three years' experience in health care reimbursement or hospital business office operations.

Strong preference for knowledge of Medicare coding and reimbursement systems for inpatient and outpatient hospital services, including CPT and HCPCS coding gained through experience.

Knowledge of charge capture, reconciliation, error management operations required.

Proficient in outpatient and inpatient charge capture operations and coding.

Comprehension of revenue cycle operations.

Strong communication skills.

Proficient in use of MS Office applications (Word, Excel), Internet applications and Outlook.

Excellent communication and organizational skills.