Senior Auditor, Billing Compliance

About the position Responsibilities • Conduct comprehensive retrospective and/or prospective coding/billing/documentation audits for multi-specialties within the medical group and/or facility departments. • Analyze source documents and associated billing documentation for coding and billing accuracy. • Audit ICD-10-CM, CPT/HCPCS or ICD-10-PCS codes for appropriateness compared to medical record documentation. • Conduct internal Compliance investigations in response to external concerns. • Identify trends or patterns of questionable coding and billing practices and report issues to Manager. • Communicate incidental findings identified in audits for potential future investigation. • Document relevant findings for all audits and investigations conducted. • Calculate reimbursement impact and statistical error rates based on findings in audits and investigations. • Facilitate communication of audit and investigational activities between internal/external customers. • Keep current on topics related to coding, billing, and documentation requirements. • Work on special projects related to Billing Compliance as assigned. Requirements • Bachelor's degree required. • Certification: RHIA, RHIT, or nurse with a coding certification (CCS, CPC) required. • 3+ years of work experience with a focus on regulatory billing compliance and/or facility/professional revenue cycle experience. • Experience with analyzing and/or auditing Revenue Cycle functions, including ICD-10, CPT, and HCPCS coding accuracy. • Experience with compliance auditing, facility and physician coding/billing practices, and PPS systems of payment preferred. Nice-to-haves • Experience with compliance auditing, facility and physician coding/billing practices, PPS systems of payment (e.g. DRG, APC, APL, HHRG, CMG) and Medicare provider-based rules preferred. • Related experience in physician and hospital inpatient/outpatient medical billing, reimbursement, chart review, coding compliance, and practice management. Benefits • Career Pathways to Promote Professional Growth and Development • Various Medical, Dental, Pet and Vision options • Tuition Reimbursement • Free Parking • Wellness Program Savings Plan • Health Savings Account Options • Retirement Options with Company Match • Paid Time Off and Holiday Pay • Community Involvement Opportunities Apply tot his job Apply To this Job