Revenue Cycle Auditor - Revenue Integrity

Summary:

Responsible for daily surveillance and problem-solving regarding departments that process patient charges. The scale and scope of this job require a hospital-based physical presence to visit areas like the OR, GI Lab, ED, Recovery, Cath Lab, Pyxis units (38 housewide), and other areas as necessary. The position is Mission Critical to identify process variances, creating guidelines and policies and procedures to increase the accuracy and timeliness of charge capture. Acts as liaison between Central Service, RBC, Accounting, Corporate Supply Chain, and other hospitals as needed to create best practices and effective and efficient operational and logistical strategies.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Works closely with and educates revenue-producing hospital departments on charge capture, charge reconciliation, late charges, unbilled claims' issues, and resolution.
• Performs timely reviews of patient accounts and remittances for denials in order to determine root cause and appropriateness, and leads corrective action plans.
• Assists in the development and implementation of action plans to mitigate risk, pertaining to revenue cycle processes and billing compliance.
• Develops detailed and summary reports on a regular basis, which are specific to the revenue cycle process and key indicators.
• Facilitates selection of patient encounters for review prior to and after patient billing for purposes of performing audits.
• Performs various analyses and provides reports to determine trends, compliance billing, impacts to net revenue, and other analytical requests pertaining to the revenue cycle.
• Works in concert with Revenue Management Team members and Revenue Integrity Teams at each facility to ensure timely gathering and reporting of applicable data.
• Leads and/or assists in the facilitation of hospital-based Revenue Integrity Teams.
• Works with Medical Records associates regarding coding issues, Patient Access on registration issues and other relevant information, Patient Financial Services, and other Revenue Cycle Departments.

Requirements:

• High School diploma or equivalent years of experience required.
• Bachelor’s Degree is preferred.
• 1 – 3 years of experience preferred.

Work Type:

Full Time

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