Revenue Integrity Auditor

Job Description

Department: Patient Fin. Services

Shift: Day

Working Hours: 8a-5p

Summary:
Responsible for the auditing of patient bills and medical record documentation to ensure accurate charging based on billing and coding guidelines. Will verify potential missing charges suggested by data analytics and internal reports.

Other information:
Minimum of one of the following licenses or certifications required: RHIT, LPN, CCS, CPC, CPC-H, or COC. Minimum of two years acute hospital inpatient and outpatient coding and/or charge auditing experience required. Minimum of two years data analysis experience using spreadsheets software such as Excel (formula writing, pivoting and importing data). Knowledge of billing guidelines from various payers (i.e., bundling CCI edits, medical necessity payment requirements, etc.). Knowledge of charge master methodologies and association with billing processed preferred. Knowledge of clinical and medical terminology. Possess required PC competencies. Self-starter, accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization.

This job will be authorized 80.00 hours bi-weekly.