Interim RAC Audit Manager

Warbird Consulting Partners, LLC; Atlanta (GA); Remote; USD 90,000 - 120,000; Full time

Job summary

A leading consulting firm is seeking an experienced Interim RAC Audit Manager to coordinate chart audits and manage denial issues. Ideal candidates should have a bachelor's degree in a healthcare-related field and significant experience with RAC audits. This remote role focuses on ensuring compliance with regulations and involves working closely with cross-departmental teams to address audit challenges.

Qualifications

• Minimum 7 years of experience in RAC and government audits.
• Familiarity with CMS regulations is required.
• Knowledge of State and Federal Regulations related to documentation.

Responsibilities

• Identify risks and trends for departmental actions.
• Coordinate to maintain database tracking system.
• Review medical records for accuracy.

Skills

Experience with RAC and government audits

Billing compliance knowledge

Strong analytical skills

Effective communication

Education

Bachelor's degree in healthcare or related field

RHIA/RHIT/CCS certification

Job description

Job Description:

Job information Interim RAC Audit Manager from the Company Warbird Consulting Partners, LLC, this latest Interim RAC Audit Manager job vacancy is located in the city Atlanta, GA located in the country United States . This latest job opening is open to job seekers who have the latest education / graduate Bachelor Degree . Job Vacancies in this Accounting field have been opened and published.

Job Responsibility:

Warbird Consulting Partners actively seeks qualified candidates for an exciting position as Interim RAC Audit Specialist for a large integrated healthcare system in Southwest. Reporting to the Senior Director of Revenue Integrity, the interim RAC Audit Specialist coordinates all activities associated with the chart audits and status tracking for Recovery Audit Contractor (RAC) and government audit related denial issues.

Warbird engages talent and expertise across all of our practice areas and assembles experienced teams to solve a wide range of complex, pressing accounting and finance issues. Our consultants typically have 15-25 years plus of industry experience and know firsthand the daily challenges our clients encounter. We fit our consultants' skills to the needs of our clients to ensure a successful experience for all.

Duration: ~ 6 -9 months

Location: Remote

Responsibilities

• Identifies risks and trends, facilitating cross-departmental tactical actions.
• Coordinates the RAC denial and appeal process and maintains the database tracking system.
• Assists with medical necessity, coding and billing reviews as they relate to the denial of issue.
• Reviews medical records and other documentation for accuracy and professional appearance, and sends RAC appeal package accordingly.
• Identifies problem claims and appeals and escalates as appropriate.
• Updates the appropriate systems to identify actions taken on the accounts.
• Performs daily appeal audit follow- up, monitoring RAC audit trends and issues and updated financial transactions.
• Monitors RAC takebacks and appeal status by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons.
• Identifies problem claims and trends and escalates as appropriate.
• Works with RAC Agencies to secure payment on account balances outstanding.
• Other duties as assigned.

QUALIFICATIONS

• Bachelor's degree in healthcare, business, Health Information Management, nursing or applicable field preferred.
• RHIA/RHIT/CCS certification.
• Minimum of 7 years of experience with RAC and government audits, denial or coding, billing, documentation and auditing in a hospital, outpatient clinical setting or physician's office required.
• Previous experience and familiarity with CMS regulations, billing compliance; Medicare, Medicaid and other third-party payer reimbursement methodologies.
• Working knowledge of State and Federal Regulations related to documentation, coding and billing.

Warbird is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, religion or other legally protected status.