Audit Coordinator

Cooper University Health Care; Auckland; On-site; NZD 60,000 - 100,000; Full time

Job summary

An established industry player in health care is seeking an Audit Coordinator to oversee external reviews and audits related to Medicare and Medicaid. This pivotal role involves establishing workflows, implementing processes, and maintaining communication with third-party auditors. The ideal candidate will have a clinical or patient accounting background, with a strong understanding of the Revenue Cycle Process. You will be responsible for analyzing audit findings, writing payer appeals, and ensuring compliance with billing documentation standards. Join a committed team dedicated to providing extraordinary health care and enjoy opportunities for professional growth and development.

Benefits

Health insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

Retirement plan

Professional development opportunities

Qualifications

• 1+ years in coordinating third-party audit review cycles.
• Knowledge of governmental regulations and billing compliance.

Responsibilities

• Coordinate external reviews/audits for Medicare and Medicaid.
• Maintain tracking systems for audit activities and appeals.

Skills

Clinical background

Patient accounting

Revenue Cycle Process knowledge

Third-party billing requirements

Billing documentation compliance

Audit coordination

Writing payer appeals

Education

Associate’s degree

Bachelor’s degree

Tools

Tracking systems for audit activity

Job description

About Us

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies, and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

Short Description

This position is responsible for the coordination of external reviews/audits, including but not limited to Medicare RAC, Medicaid RAC, or successor organizations; Medicare and/or Medicaid pre and/or post documentation requests, including but not limited to ADR, CERT, area wide and/or probe reviews.

This includes but is not limited to establishing workflows, policies and procedures, software analysis and maintenance, and implementation of processes and communication plans for the facility's interactions with third-party auditors including but not limited to pre and post payment Medicare, Medicaid, and their respective Recovery Audit Contractors (RAC) reviews to ensure timely completion of review/audit documentation requests.

This position is responsible for the oversight of all pre and post payment audit functions and is responsible for maintaining a tracking system for all audit activity throughout all levels of appeals.

The Audit Coordinator is responsible for the writing and submission of basic payer appeals, including review and submission of supporting documentation and regulations.

The Audit Coordinator will analyze review/audit findings and denials to identify problems in processes, get the information to key people to evaluate, including preparing and sending reports weekly to the Chief Compliance Officer, VP Revenue Cycle, Medical Director Utilization Management, Director of Case Management, and others as identified/assigned.

Experience Required

Must have a clinical or patient accounting background with fundamental knowledge of the Revenue Cycle Process, which includes patient access, case management/utilization review, charge capture, HIM, patient accounting, billing, and coding compliance.

In-depth familiarity with third-party billing requirements, governmental regulations, and billing documentation compliance requirements pertaining to hospital and ambulatory reimbursement.

Minimum of 1 year of experience coordinating the third-party audit review cycle from receipt of documentation request through finalizing results with payers and/or governmental agencies.

Experience writing and submitting basic payer appeals, including review and submission of supporting documentation and regulations.

Education Requirements

Associate’s degree or equivalent experience required; bachelor’s degree preferred.

License/Certification Requirements

Coding certification, such as CPC, CPC-H, CCS, CCS-P, preferred.