Revenue Integrity Auditor - Full-Time - Hybrid

CHS Career Site; Las Cruces (NM); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Competitive Pay

Medical, Dental, Vision, and Life Ins.

Generous Paid Time Off (PTO)

Extended Illness Bank (EIB)

Matching 401(k)

Opportunities for Career Advancement

Rewards & Recognition Programs

Exclusive Discounts and Perks

Job summary

Mountain View Regional Medical Center in Las Cruces, NM is seeking a Revenue Integrity Auditor to support the Business Office. The role focuses on investigating and resolving issues delaying billing and affecting reimbursement, working with Coding, HIM, and Shared Services to ensure timely processing of accounts.

The Auditor helps identify trends, reduces denials, and decreases days in DNFB by proactively resolving coding, documentation, and charge discrepancies.

Qualifications

• Bachelor's degree in a related field required or 4+ years of experience in lieu of a degree.
• 2-4 years of recent experience in Health Information Management, coding, or revenue cycle operations.
• Proficiency with DNFB, coding, and billing systems; MS Office.

Responsibilities

• Monitor DNFB and Coding Holds daily, prioritizing high-dollar accounts.
• Coordinate with ancillary departments and HIM to resolve issues blocking billing.
• Communicate with clinical departments to obtain missing documentation.
• Prepare weekly reporting detailing coding holds and outstanding documentation.
• Assist in action plans when unbilled metrics fall below corporate benchmarks.
• Maintain regular attendance and comply with all policies.

Skills

Billing workflows

HIM operations

Revenue cycle

Microsoft Office

Communication skills

Education

Bachelor's degree

Alternative experience

Tools

DNFB system

Coding systems

Billing systems

Excel

Job description

Seeking a full-time Revenue Integrity Auditor to support our Business Office department at Mountain View Regional Medical Center, located at 4311 E Lohman Ave, Las Cruces, NM.

Day Shift: Schedule to be determined.

We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.

What we Offer:

• Competitive Pay
• Medical, Dental, Vision, and Life Insurance
• Generous Paid Time Off (PTO)
• Extended Illness Bank (EIB)
• Matching 401(k)
• Opportunities for Career Advancement
• Rewards & Recognition Programs
• Exclusive Discounts and Perks

Job Summary

The Revenue Integrity Auditor supports the organization's revenue cycle by investigating and resolving issues that delay billing and impact reimbursement. This role works closely with Coding, Health Information Management (HIM), Ancillary departments, and the Shared Services Center to ensure timely and accurate processing of accounts. The Auditor also helps identify trends, minimize denials, and reduce days in DNFB (Discharged Not Final Billed) by proactively resolving coding, documentation, and charge-related issues.

Essential Functions

• Monitors and works the DNFB and Coding Holds reports daily, prioritizing high-dollar and aging accounts.
• Coordinates with ancillary departments and HIM to resolve outstanding issues preventing claims from billing.
• Communicates with clinical departments to obtain missing documentation, clarify charges, or address process delays.
• Collaborates with Coding Managers to return accounts to the appropriate queues for processing.
• Develops and distributes patient-type reports to responsible department leaders to track and resolve unbilled account holds.
• Prepares weekly corporate reporting detailing coding holds, unresolved documentation issues, and top physicians with outstanding documentation.
• Participates in weekly unbilled calls, providing status updates and identifying process barriers.
• Assists in the creation and execution of action plans when unbilled metrics fall below corporate benchmarks.
• Manages HIM support staff responsible for unbilled accounts assigned to the HIM department.
• Resolves issues related to Shared Services Center (SSI) holds, including documentation or charge discrepancies.
• Tracks unbilled alert days and submits daily trending reports to leadership.
• Serves as a resource for hospital departments to ensure documentation meets billing requirements and reduces delays.
• Acts as a backup for HIM leadership when necessary.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• Bachelor's Degree in Accounting, Finance, Health Information Management, Business Administration, or related field required or
• Four (4) plus years of direct experience in lieu of a Bachelor's degree required
• 2-4 years of recent experience in Health Information Management, coding, or revenue cycle operations required

Knowledge, Skills and Abilities

• Strong understanding of billing workflows, HIM operations, and revenue cycle processes.
• Proficiency in using DNFB, coding, and billing systems, as well as Microsoft Office (Excel, Word).
• Excellent organizational and time-management skills with attention to detail.
• Ability to work independently with minimal supervision.
• Strong written and verbal communication skills for working with clinical, coding, and operational teams.
• Ability to analyze account data and trends to proactively identify delays and resolution pathways.

Licenses and Certifications

• Certified Professional Coder (CPC) required or
• CCS-Certified Coding Specialist required