HIM Revenue Cycle Auditor I

HIM Revenue Cycle Auditor I

This position performs monthly audits of encounters, bills and chart documentation to identify revenue cycle improvement opportunities and areas of potential risk for OUTPATIENT services. This position is responsible for identifying areas of non-compliance in both the areas of coding, charge capture and revenue cycle data collection practices. Any reported issues resulting from the revenue cycle audit, this position will provide recommendations on appropriate coding, data collection and documentation behaviors. This position will be responsible for adhering to established processes and procedures throughout the organization that maintain billing integrity and compliance. This position will be responsible for maintaining current knowledge of the various regulatory agency guidelines and requirements and will work with staff and providers to ensure that all regulations are met, and that bills are subsequently submitted to a third party with accurate and compliant data.

Local candidates only. This client will not pay for travel or OT.

Duties:
* Review/analysis of coding (ICD-9, CPT 4, DRG, Revenue and HCPCS) and medical documentation associated with Inpatient Hospital encounters for accuracy and regulatory compliance
* Review/analysis of revenue cycle data using the Billing Gold Standard
* Analysis of any data changes affected by system interfaces
* Analysis of data changes affected by back-end revenue cycle activities
* Capture and report findings in an excel spreadsheet or access database
* Provide feedback and assist during the Corrective Action Process
* Provide coding assistance and feedback to ensure appropriate reimbursement, as well as to ensure that coding and documentation meet regulatory requirements
* Maintain current knowledge of coding conventions, changes and regulations