Overview:
The Revenue Auditor is responsible for auditing billing, cash collections and revenue recording for accuracy, completeness, timeliness and compliance. The Auditor will be responsible for reviewing and interpreting payor contracts, including governmental and other third-party payors, and understanding relevant regulations regarding reimbursement and documentation standards.
Responsibilities:
* Plans and conducts audits of Revenue Cycle in accordance with Generally Accepted Auditing Standards and other legal and regulatory requirements for the services provided including Medicare/Medicaid.
* Responsible for auditing daily revenue cycle reports, verifying complete and accurate reporting of revenue, receipts, discounts, etc.
* Analyze revenue cycle data to identify discrepancies, trends, and areas of improvement ensuring compliance with healthcare regulations such as HIPAA and CMS guidelines.
* Ensures that all appropriate billing charges are captured, documented, charged and reimbursed for specific departments under review, in accordance with policies and procedures, and applicable regulatory standards and requirements.
* Identifies proactive opportunities to strengthen charge capture processes and implement best practices, process improvements, internal controls and corrective action to enhance regulatory compliance and facilities appropriate revenue capture.
* Responds to third-party audits, including charge recovery audits, regulatory audits, etc.
* Provides training and education to clinical and program staff on appropriate documentation and charge capture processes.
* Abides by Bancroft's Mission Statement, Vision Statement, Core Values Philosophy of Care and Code of Ethics in promoting behavioral norms, establishing relationships and providing guidance in decision-making.
* Remains current with required training certifications; meets state-regulated licensing and regulatory accreditations; and adheres to mandatory requirements.
* Performs other duties as assigned.
Qualifications:
Bachelor's degree from an accredited college or university in accounting, finance, or healthcare administration. Minimum of five years of revenue cycle management experience and/or revenue auditing experience in a healthcare setting, with a strong preference for prior audit experience.
Special Skills
Effective written and verbal communication skills required, as well as effective interpersonal, organization and time management skills Ability to operate independently, work with confidential and sensitive information, and prioritize workload requirements. Working knowledge of Microsoft Office and Google programs required. Advanced Excel skills required.
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