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Audit

About the job

Summary:

Responsible for monitoring billing processes and makes corrections as needed. Manages the timely and accurate posting of charge data for both patient and client-billed accounts. Identifies, corrects, and maintains appropriate billing data within the information system. Ensures all claims billed meet government mandated procedures for Integrity and Compliance. Resolves insurance claim errors and regulatory edits related to billing. Handles customer billing inquiries. Serves as a resource for billing and compliance activities.

Responsibilities:

Researches, identifies and submits appropriate coding/billing requests

Acts as the technical expert

Performs pre-submission audit of coding/documentation and monitoring of activities to ensure compliance billing and internal standards are met in accordance with national reimbursement agencies' standards and regulations (Medicare/Medicaid).

Maintains knowledge of all insurance/payer billing requirements

Identifies trends in billing issues, system issues and payer specific requirements.

Maintains knowledge of the Meditech computer system and the electronic billing system, and ensures that system features are used effectively to support billing activity.

Audits and reconciles each department to ensure all billable services/items are charged appropriately.

Maintains Charge Master files and routinely reviews professional and technical charges updating per compliance guidelines.

Identifies opportunities to recoup and prevent potential future loss of billing revenue.

Provides technical support to the hospital's coding team to ensure accurate coding and billing.

Performs other duties as assigned.

Requirements:

Education/Skills

Highschool diploma or GED.

Certified Coder preferred

Computer literacy required, specifically in Microsoft Office.

Must be proficient with spreadsheets and word processing applications.

Working knowledge of financial accounting and billing procedures.

Completion of Medical Terminology and anatomy/physiology courses, medical coding/billing certification, or related experience is required in order to classify procedure codes.

Experience

Minimum four years extensive CPT and ICD9/10 CM coding experience required.

Thorough knowledge of applying third party and government payor regulations required.

Licenses, Registrations, or Certifications

Medical billing certification, preferred

Medical coding certification, preferred

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time