Revenue Auditor

• Performs weekly audits of the chargemaster to ensure charge accuracy and compliance with all pricing.
• Performs routine audits of each hospital departments Posted Charges reports in order to maximize charge capture.
• Facilitates development of strategies to improve reimbursement after identifying trends that negatively impact revenue capture.
• Performs routine audits of each hospital departments Posted Charges reports in order to maximize charge capture and ensure correct reporting of medical services.
• Performs weekly audits of the chargemaster to ensure charge accuracy and compliance with all pricing.
• Liaises with the Analyst Clinical Billing Compliance and Systems & Contracts Specialist to implement changes in the chargemaster and/or Contract Management that were identified during routine audits.
• Analyzes coding and charging by Outpatient departments following billing guidelines for high riyal departments, i.e.; Emergency Room, Specialty Clinics, procedures performed within the clinics.
• Actively seeks opportunities to positively impact Revenue Integrity workflows and metrics, utilizing experience to identify process improvement needs and to design and implement best practices.
• Works with other departments, physician offices and the Training Specialist to adapt best practices to changing needs within the healthcare environment. Escalates issues to Manager when a department is not responsive to suggestions for preventing revenue loss.

Education

Bachelors Degree in commerce, health information or relevant discipline.

Experience

3+ years of experience in healthcare compliance, auditing, quality control, finance, and medical affairs. Extensive knowledge of medical devices or the pharmaceutical industry is highly relevant.

Certification and Licensure

Prefer Coding certification for hospital and/or physician

Professional Membership

Job Specific Skills and Abilities

• Requires knowledge of US Medicare regulations and NCCI Edits.
• Timely completion of tasks.
• Proficiency with Microsoft Office suite
• Fluency in written and spoken English