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What you will be doing in this role:

Under the general direction of the Manger or Associate Director, the Revenue Auditor Service Line performs audits of medical records against submitted professional charges/the itemized bill and performs special audit requests for the department. The Revenue Auditor Service Line performs daily reconciliation of the submitted professional charges by all providers in the department against completed documentation and the daily census. Your responsibilities will include handling hospital billing primarily, while assisting in the corrections of professional billing for Invasive Cardiology (CVIC). However, the new employee will be cross trained in Non-Invasive Cardiology (NIC), Cardiothoracic Surgery (CTS), and other SHI subspecialties coding and charges activities. Other duties include:

• Daily review and clear 40 - 50 accounts (sophisticated diagnostic and therapeutic procedures)
• Daily follow-up with providers, clinical staff, the Coding department, Billing Compliance, and Revenue Integrity.
• Review and create a daily statistical log of all patients, procedures, and participants. Monitor and track all unbilled services by providers and follow through with each provider accordingly.
• Performs daily, weekly, and monthly reconciliation of technical and professional services rendered by the department providers against charges posted/billed by PBS to ensure maximum revenue.
• Performs quality assurance reviews of account documentation or account adjustments and provides findings to management staff as needed. Makes monthly observations and recommendations to prevent future cash losses.
• Coordinates and reports audit outcome regarding charge errors, percentage of savings or losses, data processing errors, the performance of hospital charging system, and documentation.
• Conducts fact-finding, organizes, and presents information in a manner that facilitates patient account management system process, troubleshooting and improvement efforts.
• Investigates any appearance of production anomalies and initiates or coordinates action to resolve identified issues or difficulties.
• Performs recurring data compilations from varied sources to inform management team of receivable status.
• Coordinates or monitor progress of special projects related to resolving identified accounts receivable concerns.
• Serves as co-administrator of patient accounting system applications that enable automated work-listing and adjusting of accounts.
• Responsible for auditing clinic charge capture in department.
• Prepares the monthly Accounts Receivable (AR) valuation report and assists with AR reduction projects as requested.
• Participates in month-end impact projects, such as identification of accounts missing contractual adjustment and calculating and posting missing adjustments.
• Coordinates and/or monitors progress of special projects related to resolving charge capture and accounts receivable concerns.
• Serves as liaison between the department?s team and Professional Billing Services (PBS).

Requirements:

• High school diploma/GED required. Associate's degree or college diploma with courses in business, accounting, computer operation and applications preferred.
• A minimum of one year of charge auditing experience required, with three years preferred. Coding experience a plus.

Why work here?

Beyond outstanding employee benefits (including health, vision, dental and life and insurance) we take pride in hiring the best employees. Our accomplished and compassionate staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation.