Medical Chart Auditor

Job Description We are seeking a Medical Chart Auditor whose primary responsibilities involve verifying, rectifying, and finalizing edits in the Patient Accounting System or claims editing system. Occasionally, the Medical Chart Auditor will conduct insurance audits in conjunction with chosen payer auditors as per contract stipulations. The role also encompasses communication within the hospital department regarding charge disputes, charge capture, and waiting documentation. Key Responsibilities Collaborate with hospital departments such as the PFS Business Office and insurance/payers on audits, disputed charges, and hospital billing issues. Regularly engage with department directors concerning outstanding documentation or charging problems. Conduct accurate and timely charge audits or billing edits as needed. Assist in the onboarding and training of new recruits or contract/contract team members. Adhere to USC University Hospital's guidelines. Engage with insurance firms or auditing services to address any grievances or carry out defense audits. Update the department charge master and respond to department requests in a timely and accurate fashion. Address any billing, charging, or documentation difficulties with relevant hospital departments. Identify and resolve any pre-existing charging issues. Organize and carry out extensive defense audits of patient medical records with insurance company representatives to confirm supportive documentation for the hospital. Correct charges and coordinate re-bills based on agreed audit results. Validate and handle bill holds related to charge reviews held by Risk Management, coordinating approvals and bill release process. Carry out concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly, identifying charging issues and departmental deficiencies. Work consistently on DNFB and PFS claim edits worklists to ensure timely completion per Keck USC policies and monthly targets. Provide support to the Director of Revenue Analysis and Director of A/R Management as required. Perform any other duties and responsibilities as directed. Required Qualifications Coding experience. Certified preferred Charging experience. CDM experience. Facility billing experience. High school diploma or its equivalent. Ability to read, write, and follow both written and verbal instructions. Familiarity with the operation of the Medical Record Department. Excellent organizational skills with the ability to manage multiple tasks and deadlines efficiently. Proficiency in the operation of standard office equipment such as scanners, fax machines, multi-line telephone systems, and copy machines. Ability to work independently and in a team. Capability to maintain the confidentiality of sensitive information. Preferred Qualifications Graduation from an accredited program such as LVN, RN, Certified Coding Specialist, or detail-oriented Coder. A minimum of one-year experience in medical auditing or HIM coding. Excellent computer and keyboarding skills, with proficiency in PC, Windows, and Excel. Relevant certification such as Licensed Vocational Nurse - LVN (CA DCA), Registered Nurse - RN (CA DCA), Certified Coding Specialist - CCS (AHIMA), or Certified detail-oriented Coder - CPC (AAPC). #J-18808-Ljbffr 6AM City, LLC