Medicare Audit Coordinator jobs in United States
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Reunion Rehabilitation Hospitals · 2 days ago

Medicare Audit Coordinator

Reunion Rehabilitation Hospitals is seeking a Medicare Audit Coordinator to manage the healthcare facility's response to Review Choice Demonstration claims. The role involves coordinating documentation, managing timelines, and analyzing findings for the RCD Project while ensuring compliance with CMS regulations.

Health CareHospitalRehabilitation

Responsibilities

Acts as the main liaison for all RCD-related activities, communicating between departments including providers, Case Managers, Admissions, and Therapy
Submits required documentation, tracks, monitors, and ensures timely submission of requested patient medical records for RCD pre-claim review
Coordinates the timely filing and management of appeals for denied claims
Performs audits, analyzes findings, identifies trends, and reports results to management
Ensures adherence to CMS (Centers for Medicare & Medicaid Services) regulations for the RCD program
Identifies opportunities for streamlining operations and process related to RCD

Qualification

Medicare RegulationsData AnalysisDocumentation SkillsComputer SkillsInterpersonal SkillsProblem-Solving SkillsAttention to DetailCommunication Skills

Required

1+ Prior experience with compiling patient records in preparation for audit and analyzing results
Strong interpersonal skills as well as computer skills are required for hospital communication
Strong computer skills, particularly Word, Excel, Adobe Acrobat applications
Strong Knowledge of IRF and Medicare Regulations: A thorough understanding of IRF admission criteria, Medicare coverage rules, and RCD requirements is essential
Excellent Documentation Skills: Ability to review and analyze documentation for accuracy and completeness
Strong Communication and Interpersonal Skills: Ability to effectively communicate with staff, corporate team, and Novitas
Problem-Solving and Analytical Skills: Ability to update the RCDT, analyze trends, and improve the tracking system as needed
Attention to Detail: Meticulous attention to detail is crucial for accurate documentation review and compliance
Detail-oriented, able to meet strict time frames

Preferred

Acts as the main liaison for all RCD-related activities, communicating between departments including providers, Case Managers, Admissions, and Therapy
Submits required documentation, tracks, monitors, and ensures timely submission of requested patient medical records for RCD pre-claim review
Coordinates the timely filing and management of appeals for denied claims
Performs audits, analyzes findings, identifies trends, and reports results to management
Ensures adherence to CMS (Centers for Medicare & Medicaid Services) regulations for the RCD program
Identifies opportunities for streamlining operations and process related to RCD

Benefits

A supportive and collaborative work environment
Opportunities to progress in function, skill, and pay
A competitive wage scale
A comprehensive health and wellness package including medical, dental, and prescription drug coverage
401k
Life insurance
Disability plans

Company

Reunion Rehabilitation Hospitals

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Reunion Rehabilitation Hospitals is a rehabilitation hospital that provides individualized care plans for your specific needs. It is a sub-organization of Nobis Rehabilitation Partners.

Funding

Current Stage
Growth Stage

Leadership Team

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Lonnie Martinez
Chief Executive Officer
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Shawn M.
Chief Executive Officer
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Company data provided by crunchbase