ECLARO ยท 14 hours ago
Auditor
Chicago, IL
Contract
Onsite
Mid, Senior Level
$50/hr - $50/hr
5+ years expECLARO is a leading provider of healthcare workforce software and solutions, currently seeking an Auditor in the Chicago, IL area. The Auditor will conduct reviews of EMR documentation to ensure coding accuracy and work collaboratively with clinical providers to enhance revenue cycle integrity.
Staffing & Recruiting
Responsibilities
Coordinates, schedules, and performs reviews of professional services and documentation performed by RUMG & ROPPG providers
Evaluates clinical documentation to identify inconsistency or improvement opportunities that could impact reimbursement, revenue integrity, and/or reduce denials
Reviews charge information submitted by certified coders, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing is being performed in an accurate and timely manner and is supported by documentation
Prepares written reports of the audit findings to internal leadership, clinical leadership, and providers
Develops educational presentations, learning tools, and training material
Provides education for both providers and coders for appropriate CPT, ICD-10, and modifiers based on supporting documentation and EMR charge capture support
Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle
Seeks to establish collaborative relationships with physician leaders, clinical providers, IS, Corporate Compliance, Revenue Cycle, and administrative leadership in the support of coding education and documentation adequacy
Assists with claim denial reports to ensure optimal reimbursement
Analyzes billing trends to identify areas of noncompliance and prepares regular reports on review
Assists in the development of corrective action plans and participates in compliance investigations as needed
Manages special projects individually or in collaboration with other departments
Track coding quality and documentation improvements to measure ROI, organizational growth and support of CPI initiatives
Performs job functions adhering to service principles with customer service focus on I-Care values
Qualification
Required
Bachelor's Degree in lieu of bachelor's degree, an associate's degree with 5 years of auditing experience required
Certified Professional Coder (CPC) or Certified Coding Specialist- Physician Based (CCS-P)
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification in conjunction with physician-based coding experience, including evaluation & management (E/M) and surgical coding experience, may be considered contingent upon CPC or CCS-P certification being acquired within the first 6 months of employment
Three years of E/M and/or surgical coding experience
Extensive knowledge of federal, state, and payer specific regulations and policies pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines
Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in CPT, ICD-10-CM and HCPCS code assignment by passing a department administered coding proficiency test
Demonstrates commitment to continuous learning and performs as a role model to other coding staff
Strong communication and organizational skills
Preferred
Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications
Experience working in a Teaching Hospital setting
Prior experience with billing and claims processing
Prior experience working in a hospital or clinical setting
Proficient in Excel, Word, Data Entry
Benefits
401k Retirement Savings Plan administered by Merrill Lynch
Commuter Check Pretax Commuter Benefits
Eligibility to purchase Medical, Dental & Vision Insurance through ECLARO
Company
ECLARO
ECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada and the Philippines.
1001-5000 employees
H1B Sponsorship
ECLARO has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
2024 (1)
2023 (1)
2022 (2)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Nicholas Butcher
QA CTO Label Specialist
Dan Broderick
Chief Delivery Officer
Company data provided by crunchbase