Revenue Integrity Anesthesia Auditor

150 Shriners Hospitals for Children; United States; Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

Shriners Children's is hiring an Anesthesia Auditor to systematically review anesthesia records for accuracy, completeness, and regulatory compliance. The role supports quality assurance, billing integrity, and education across departments.

The candidate will verify provider signatures, ensure CMS and Joint Commission alignment, and collaborate with billing and compliance teams. A Bachelor’s degree in a healthcare field and 5+ years of auditing experience are preferred.

Qualifications

• Minimum 5 years' experience in medical chart review, medical auditing, or clinical documentation.
• Functional knowledge of DRG and CPT coding systems.
• Proficiency with Epic EMR.

Responsabilités

• Perform comprehensive review of anesthesia records for accuracy and completeness.
• Verify provider signatures on documentation (anesthesiologist, CRNA, supervising physician).
• Ensure adherence to CMS, Joint Commission, and state billing requirements.
• Identify gaps in documentation and follow up with providers to obtain signatures.
• Monitor and report recurring errors to support process improvement and education.
• Collaborate with billing, compliance, and clinical teams on regulatory and process needs.
• Handle medical records per HIPAA and organizational policies.
• Conduct audits of Hospital, Ambulatory Surgery Center, and Outpatient Clinic records to ensure charges are supported.

Connaissances

Medical chart review

Medical auditing

Clinical documentation

Formation

Bachelor's Degree in Nursing, HIM, or related healthcare field

Outils

Epic EMR

Description du poste

Company Overview

Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families. With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family's ability to pay or insurance status.

Job Description

The Anesthesia Auditor is responsible for the systematic review of anesthesia records to ensure accuracy, completeness, and compliance with regulatory and institutional standards. Primary responsibilities include verifying that all required documentation, provider signatures, and charges are present and appropriately supported. This role plays a key part in supporting quality assurance and regulatory compliance within the anesthesia department. The Anesthesia Auditor will also assist with other auditor duties as assigned. Every day, we provide innovative, compassionate care and conduct leading research that enhances the quality of life for children and their families.

Key Responsibilities

• Comprehensive review of anesthesia records to ensure documentation accuracy and completeness
• Verify that all required provider signatures- including those of the anesthesiologist, CRNA, and supervising physician- are present on the documentation
• Maintain adherence to internal protocols, external regulatory standards- including CMS and the Joint Commission- and all applicable billing requirements; additionally, identify all state-specific requirements necessary for compliance and billing in each jurisdiction (e.g., anesthesia assistants, supervision mandates, provider scope of practice)
• Detect gaps in documentation and follow up with providers to ensure completion and signature requirements are met
• Monitor, track, and report recurring errors or documentation trends to providers to support process improvement initiatives and education
• Collaborate with billing, compliance, and clinical departments to address documentation, regulatory, and process-related needs
• Ensure the secure and confidential handling of all medical records and patient information in accordance with HIPAA and organizational policies
• Conduct detailed Hospital, Ambulatory Surgery Center, and Outpatient Clinic audits to ensure all charges are captured, supported by orders, and appropriately documented; additionally, review audit findings with the appropriate representative
• Execute special audits on an ongoing basis, summarizing results for executive leadership and coordinating education and training efforts as needed
• Analyze billing and compliance issues through the lens of federal and state healthcare regulations, as well as payer guidelines to ensure regulatory compliance
• Deliver targeted education on billing and compliance matters identified during reviews or upon request from facilities, administration, and management, employing webinars, presentations, bulletins, newsletters, SHINE modules, and other appropriate tools

Required Qualifications

• Minimum of 5 years' experience in medical chart review, medical auditing, or clinical documentation
• Functional knowledge of DRG and CPT coding systems
• Proficiency with Epic EMR
• Bachelor's Degree in Nursing, HIM, or related healthcare field - in lieu of degree, equivalent experience of at least 5 years in auditing and monitoring may be substituted for a degree

Preferred Qualifications

• Prior experience with anesthesia services or perioperative documentation
• Familiarity with regulatory requirements (e.g., CMS the Joint Commission, ASA guidelines)
• RHIA or RHIT certification

Compensation

Compensation is determined based on years of relevant experience and departmental equity.

Locations

No matter where you're located, you'll find openings at our Shriners Children's facilities across the U.S., in Canada and Mexico and at our corporate headquarters in Tampa, Florida.

Benefits

Eligible Shriners Children's employees receive comprehensive benefits packages, including medical, dental and vision insurance, tuition assistance, retirement matching and so much more!