Remote Revenue Integrity Auditor

MedStar Health; Norfolk (VA); Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Revenue Integrity Auditor in Norfolk, VA, responsible for auditing medical records to ensure accuracy and compliance with healthcare billing regulations. The ideal candidate will have at least 3 years of healthcare appeals experience and a Bachelor's degree. This position offers a comprehensive benefits package including medical plans, tuition assistance, and more.

Benefits

Medical, Dental, Vision plans

Tuition Assistance

401k/403B with Employer Match

Paid Time Off and Sick Leave

Long-Term and Short-Term Disability plans

Qualifications

• 3 years of healthcare appeals experience required.
• Bachelor's degree or 4 years of relevant experience.
• Strong analytical and organizational skills needed.

Responsibilities

• Perform detailed audits of medical records.
• Manage documentation requests and reviews.
• Establish workflows for interactions with auditors.

Skills

Healthcare appeals experience

Attention to detail

Analytical skills

Education

Bachelor's degree

Job description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

The Revenue Integrity Auditor will perform detailed audits of the medical records at Sentara facilities, researching and analyzing the accuracy of documentation to ensure charges are defensible under scrutiny with payers. The auditor ensures adherence to regulatory requirements related to billing and supporting documentation, facilitates the completion of appeals in a timely manner, identifies discrepancies in patient charges, and collaborates on engagements involving payer contracts, regulatory compliance, revenue integrity, and operational assessments. This position is responsible for coordinating external reviews/audits, including Medicare, Medicaid, or Commercial payers, and managing documentation requests and reviews.

Key Responsibilities

This includes establishing workflows, policies, procedures, and communication plans for interactions with third-party auditors, ensuring timely completion of reviews and audits for Medicare, Medicaid, and commercial insurances.

This position oversees all pre- and post-payment audit functions, manages medical documentation requests, and maintains a tracking system for all audit activities and appeals.

Education:

• Bachelor's degree (Required)
• Candidates with 4 years of healthcare appeals experience may be considered in lieu of a degree.

Experience:

• 3 years of healthcare appeals experience (Required)

Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans
• Reimbursement for adoption, fertility, and surrogacy up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and access to CEUs and professional development
• Pet Insurance, Legal Resources Plan, and opportunities for annual bonuses based on system and employee criteria

Equal Opportunity Employer

Sentara Health is committed to diversity and inclusion, reflecting the communities it serves. It is a tobacco-free environment. For remote positions, associates are employed in specified states including Virginia and others listed.