Charge Audit Specialist - Remote

Conifer Health Solutions; Frisco (TX); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a Charge Audit Specialist to enhance billing accuracy and compliance in a remote role. This position is vital for ensuring that all billing charges are captured and documented according to regulatory standards. The specialist will conduct audits, collaborate with clinical departments, and provide training to staff, making a significant impact on revenue capture and compliance. If you have a passion for healthcare billing and a keen eye for detail, this opportunity offers a chance to contribute to a vital aspect of healthcare operations while working remotely.

Qualifications

• Experience in billing audits and compliance with regulatory standards.
• Strong analytical skills for identifying billing errors and opportunities.

Responsibilities

• Conduct audits to identify billing issues and prepare reports.
• Collaborate with departments to address audit findings and implement best practices.
• Provide training to staff on billing data entry and charge reconciliation.

Skills

Billing Audits

Regulatory Compliance

Data Analysis

Training and Development

Education

Bachelor's Degree in Healthcare Administration

Certification in Medical Billing and Coding

Job description

Join to apply for the Charge Audit Specialist - Remote role at Conifer Health Solutions.

This job is responsible for ensuring that all appropriate billing charges are being captured, documented, charged, and reimbursed for the assigned department in accordance with policies, procedures, and applicable regulatory standards and requirements. It involves planning, conducting, and evaluating reviews and audits of clinical documentation and billing practices for conformity with regulatory requirements. The role includes identifying opportunities to strengthen charge capture processes, enhance compliance, and facilitate revenue capture. Additionally, it involves responding to third-party audits and charge recovery vendor audits, as well as providing training to clinical and billing staff on documentation and charge capture processes.

Essential Duties and Responsibilities:

1. Conduct reviews and audits to identify potential billing issues and lost revenue opportunities; prepare reports and summarize findings for impacted departments.
2. Collaborate with clinical and impacted departments to address audit findings and implement best practices.
3. Research and analyze billing errors or omissions, working with relevant staff to ensure timely revisions and corrections.
4. Provide training to staff involved in billing data entry and charge reconciliation to ensure understanding and accuracy.
5. Stay current with CMS, AHA, and state coding and reimbursement guidelines.
6. Perform other duties as assigned, including root cause analysis, complex issue research, and system upgrade support.