Auditor, Revenue Optimization (Remote)

Melville,NY - USA

Position Requirements

RESPONSIBILITIES

• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities.
• Perform Root Cause Analyses and report findings that identify common issues, including over-coding, under-coding and missed billing opportunities.
• Retrieves any missing patient information and documentation required for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes.
• Assist with Clinical Documentation recommendation, coding guidance research, and the development of coding educational documents
• Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution.
• Pre-payment audit: review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and/or identify CDI (Clinical Documentation Improvement) opportunities
• Provide resolution of missing documentation tasks. Retrieve or request necessary documents, code for billing, and data entry.
• Provide coding support to cross-functional team inquiries and special projects.

REQUIRED QUALIFICATIONS

• Minimum 3 years coding experience.
• Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
• Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment.
• Extensive knowledge of medical billing software and electronic medical records.
• Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process.
• Proficient PC skills, including Microsoft 365.
• Excel Proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables).
   

PREFERRED QUALIFICATIONS

• Previous coding experience within Anesthesia or General Surgery.
• Clinical Documentation compliance and regulatory requirements.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.