Revenue Optimization Auditor (Remote)

North American Partners in Anesthesia; United States; Remote; USD 58,000 - 78,000; Full time

Benefits offered by this job

Paid Time Off

Health, life, vision, dental, and AD&D

401(k)

Professional development

Job summary

North American Partners in Anesthesia in Sunrise, FL is seeking an Auditor, Revenue Optimization to audit medical records for billing accuracy and perform root cause analyses on coding variances. You will retrieve missing documentation, complete coding of unbilled records, and prepare executive summaries of audit findings for presentation.

The role requires 3+ years coding experience and an approved coding credential (AAPC/AHIMA) with potential CPMA/CANPC within 1 year; strong billing software

Qualifications

• Minimum 3 years coding experience.
• Must have and maintain an approved coding credential through AAPC or AHIMA.
• Must have or obtain at least one additional certification (CANPC or CPMA) within 1 year of employment.
• Extensive knowledge of medical billing software and electronic medical records.
• Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process.
• Proficient PC skills, including Microsoft 365.
• Excel proficiency including formulas, concatenate, VLOOKUP, and pivot tables.

Responsibilities

• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies.
• Perform Root Cause Analyses and report findings identifying common issues, including over- and under-coding.
• Retrieve missing patient information and documentation required for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports, executive summaries, and examples of audit findings for presentation.

Skills

CMS guidelines knowledge

Revenue Cycle knowledge

MS 365 proficiency

Excel familiarity

Education

AAPC or AHIMA credential

CANPC or CPMA certification

Tools

Billing software

EMR software

Microsoft 365

Job description

Position Requirements

Sunrise,FL - USA

RESPONSIBILITIES

• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities.
• Perform Root Cause Analyses and report findings that identify common issues, including over-coding, under-coding and missed billing opportunities.
• Retrieves any missing patient information and documentation required for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes.
• Assist with Clinical Documentation recommendation, coding guidance research, and the development of coding educational documents
• Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution.
• Pre-payment audit: review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and/or identify CDI (Clinical Documentation Improvement) opportunities
• Provide resolution of missing documentation tasks. Retrieve or request necessary documents, code for billing, and data entry.
• Provide coding support to cross-functional team inquiries and special projects.

REQUIRED QUALIFICATIONS

• Minimum 3 years coding experience.
• Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
• Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment.
• Extensive knowledge of medical billing software and electronic medical records.
• Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process.
• Proficient PC skills, including Microsoft 365.
• Excel Proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables).

PREFERRED QUALIFICATIONS

• Previous coding experience within Anesthesia or General Surgery.
• Clinical Documentation compliance and regulatory requirements.

Total Rewards:

• Salary: $58,000 - $78,000 annually
• Generous benefits package, including:
  • Paid Time Off
  • Health, life, vision, dental, disability, and AD&D insurance
  • Flexible Spending Accounts/Health Savings Accounts
  • 401(k)
  • Leadership and professional development opportunities

The Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding/ billing issues, participating in external/internal audit requests, payer audits, and special projects as needed.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.